Preoperative Temporary Discontinuation of Aspirin Medication Does Not Increase the Allogeneic Transfusion Rate and Blood Loss in Primary Total Hip Arthroplasty

PURPOSE: This study aims to determine whether preoperative temporary discontinuation of aspirin (100 mg/d) use is a safe procedure does not increase blood loss and the need for transfusion after total hip arthroplasty (THA). MATERIALS AND METHODS: This study retrospectively reviewed 219 patients who underwent consecutive primary THA from January 2012 to December 2018. They were divided into the experimental group (42 cases) that discontinued aspirin intake 7 days before surgery and the control group (150 cases) that had no history of use of antiplatelet agents. To compare initial blood loss between the two groups, we analyzed the changes hemoglobin (Hb) levels and hematocrit values measured preoperatively and in lowest values measured during three days after surgery. In addition, transfusion rate was compared within the first two postoperative weeks between the two groups. A multiple logistic regression was performed to assess the association of transfusion with age, gender, use of antiplatelet agents, preoperative anesthetic risk, body weight and preoperative Hb. RESULTS: No statistically significant difference was found in the changes in lowest Hb level (P=0.30) and hematocrit value (P=0.14) measured preoperatively and for three days after surgery between the experimental group and the control group. There was no statistically significant association between transfusion and the use of antiplatelet agents, and preoperative Hb level was identified as a factor that affected the need for transfusion (odds ratio, 0.427; P=0.001). CONCLUSION: Preoperative temporary discontinuation of aspirin use for 7 days before surgery did not increase initial blood loss after THA and the need for transfusion in the first two postoperative weeks compared to patients with no history of use of antiplatelet agents.