title: [Low-dose aspirin doesn't increase surgical bleeding nor transfusion rate in total knee arthroplasty].
abstract: OBJECTIVE
  Surgical bleeding. transfusion rate and cardiovascular complications were analized in patients undergoing chronic treatment with low-doses aspirin and scheduled to unilateral primary knee arthroplasty.
  
  
  METHODS
  We retrospectively studied 117 patients between 2005 and 2006 scheduled for elective knee replacement that received antiplatelet therapy with aspirin (100mg/day). Aspirin medication was maintained or discontinued preoperatively according to medical criteria. We analyzed the biological, clinical and anesthetic data, blood-saving techniques used, surgical bleeding, allogeneic blood transfusion rate, cardiocirculatory complications (myocardial, cerebral or peripheral ischemia), hospital stay and mortality. This population was compared with 190 patients (control group) who underwent the same operation at the same time interval but did not receive aspirin therapy.
  
  
  RESULTS
  The aspirin-treated group was significantly older, with higher weight and poorer health state (higher incidence of ischemic heart disease, cerebral ischemia and diabetes). The hidden and external surgical bleeding and transfusion rate were similar if the aspirin were interrupted or not, preoperatively. Bleeding and transfusion rates were independent of time of interruption of the aspirin. Hospital mortality was zero in the 2 groups. A acute myocardial infarction and a transient stroke happened in two patients wich aspirin treatment was discontinued.
  
  
  CONCLUSIONS
  Preoperative treatment with low doses of aspirin does not increase surgical bleeding and transfusion rate in total knee arthroplasty. Preoperative discontinuation can cause severe cardiocirculatory complications.
authors.affiliation: Servicio de Anestesiología, Hospital Mar-Esperança, Parc de Salut Mar, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Castillo Monsegur
authors.forename: E
authors.initials: E
authors.lastname: Bisbe Vives
authors.forename: X
authors.initials: X
authors.lastname: Santiveri Papiol
authors.forename: R
authors.initials: R
authors.lastname: López Bosque
authors.forename: A
authors.initials: A
authors.lastname: Ruiz
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage / Q000706:statistics & numerical data; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D011229:Preanesthetic Medication / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin