4 ms·

Is there any risk of the thinner blood leaving you predisposed to complications in the event of an unrelated traumatic injury? ..analagous to how Amber died in

by cmsd2 9y ago

Is there any risk of the thinner blood leaving you predisposed to complications in the event of an unrelated traumatic injury? ..analagous to how Amber died in season 4 of House?

Bartweiss 9y ago
Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.) It's not necessarily external trauma, but major bleeding events, especially internal, are more prevalent and severe on aspirin. The NNT/NNH breakdown suggests that heart attack and stroke prevention narrowly beats out increased bleeding, but it's not unambiguous. (Normally you handle this by recommended preventatives to people at high risk so you get a better ratio. This sometimes works with aspirin, but older people are often at high risk for stroke and bleeding, so the problem sticks around.) I don't know how cancer prevention factors in - it might push aspirin into clear net-positive territory - but regardless you're right about blood thinners creating trauma risk.
- masklinn 9y ago
  > Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.) Liver is paracetamol — aside from Reye Syndrome[0] — aspirin is metabolised via the kidneys and I believe even overdoses does not overload the kidneys[1], however aspirin inhibits excretion of uric acid which is why it's contra-indicated to people suffering from gout or kidney diseases. [0] https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Reye_syndrome linked to both aspirin and liver toxicity [1] in fact one part of aspirin overdose protocol is urinary alkalinization: increasing urinary pH from ~5 to ~8 increases renal elimination of salicylate by 10~20x
  - Bartweiss 9y ago
    Ah, thanks. I knew I'd heard of aspirin-liver related crises, but I hadn't realized Reye Syndrome happened outside of normal metabolism!
- aantix 9y ago
  >Are more prevelent As for the internal bleeding risks. https://books.google.com/books?id=j-XQ1UqLdAQC&pg=PT41&lpg=PT41&dq=%22These+results+translate+into+an+absolute+rate+increase+with+aspirin+above+placebo%22&source=bl&ots=FyqSUgT6MY&sig=M-dT_HBgARMHsfecKljNbFSmats&hl=en&sa=X&ved=0ahUKEwjF9MbQkJvXAhXHgVQKHemhDMoQ6AEIMTAB#v=onepage&q=%22These%20results%20translate%20into%20an%20absolute%20rate%20increase%20with%20aspirin%20above%20placebo%22&f=false https://books.google.com/books?id=j-XQ1UqLdAQC&pg=PT41&lpg=P... "These results translate into an absolute rate increase with aspirin above placebo (the incidence of cases of major GI bleeding attributable to low-dose aspirin) of 0.12% per year (95% CI: 0.070.19% per year).[20] Based on this value, 833 patients (95% CI: 5261429 patients) would need to be treated with low-dose aspirin instead of placebo to cause one major GI bleeding episode during a 1-year period (i.e. the NNH is 833)"
- smileysteve 9y ago
  > it might push aspirin into clear net-positive territory It's pretty clearly in the net positive territory. Reduces sunburn, reduces obesity, can stop a heart attack or stroke immediately, cures hangovers, and reduces cancers.
idclip 9y ago
Oh yes. You /will bleed/ more. Has no effect on healing as far as i can see, and i cut myself now and then regularly. (i cook alot) but i heal quickly. Now if i ever cut into a large blood vessel... Yeah ill be in trouble. If you consider doing dental work though, please let your dentist know. Hospitals ask about aspirin if they want to do surgery.

by cmsd2 9y ago

Is there any risk of the thinner blood leaving you predisposed to complications in the event of an unrelated traumatic injury? ..analagous to how Amber died in season 4 of House?

Bartweiss 9y ago

Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.) It's not necessarily external trauma, but major bleeding events, especially internal, are more prevalent and severe on aspirin. The NNT/NNH breakdown suggests that heart attack and stroke prevention narrowly beats out increased bleeding, but it's not unambiguous. (Normally you handle this by recommended preventatives to people at high risk so you get a better ratio. This sometimes works with aspirin, but older people are often at high risk for stroke and bleeding, so the problem sticks around.) I don't know how cancer prevention factors in - it might push aspirin into clear net-positive territory - but regardless you're right about blood thinners creating trauma risk.

masklinn 9y ago
> Yes, that's the main reason aspirin isn't recommended more widely. (Stomach and liver harm are the other big reasons.) Liver is paracetamol — aside from Reye Syndrome[0] — aspirin is metabolised via the kidneys and I believe even overdoses does not overload the kidneys[1], however aspirin inhibits excretion of uric acid which is why it's contra-indicated to people suffering from gout or kidney diseases. [0] https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Reye_syndrome linked to both aspirin and liver toxicity [1] in fact one part of aspirin overdose protocol is urinary alkalinization: increasing urinary pH from ~5 to ~8 increases renal elimination of salicylate by 10~20x
- Bartweiss 9y ago
  Ah, thanks. I knew I'd heard of aspirin-liver related crises, but I hadn't realized Reye Syndrome happened outside of normal metabolism!
aantix 9y ago
>Are more prevelent As for the internal bleeding risks. https://books.google.com/books?id=j-XQ1UqLdAQC&pg=PT41&lpg=PT41&dq=%22These+results+translate+into+an+absolute+rate+increase+with+aspirin+above+placebo%22&source=bl&ots=FyqSUgT6MY&sig=M-dT_HBgARMHsfecKljNbFSmats&hl=en&sa=X&ved=0ahUKEwjF9MbQkJvXAhXHgVQKHemhDMoQ6AEIMTAB#v=onepage&q=%22These%20results%20translate%20into%20an%20absolute%20rate%20increase%20with%20aspirin%20above%20placebo%22&f=false https://books.google.com/books?id=j-XQ1UqLdAQC&pg=PT41&lpg=P... "These results translate into an absolute rate increase with aspirin above placebo (the incidence of cases of major GI bleeding attributable to low-dose aspirin) of 0.12% per year (95% CI: 0.070.19% per year).[20] Based on this value, 833 patients (95% CI: 5261429 patients) would need to be treated with low-dose aspirin instead of placebo to cause one major GI bleeding episode during a 1-year period (i.e. the NNH is 833)"
smileysteve 9y ago
> it might push aspirin into clear net-positive territory It's pretty clearly in the net positive territory. Reduces sunburn, reduces obesity, can stop a heart attack or stroke immediately, cures hangovers, and reduces cancers.

idclip 9y ago

Oh yes. You /will bleed/ more. Has no effect on healing as far as i can see, and i cut myself now and then regularly. (i cook alot) but i heal quickly. Now if i ever cut into a large blood vessel... Yeah ill be in trouble. If you consider doing dental work though, please let your dentist know. Hospitals ask about aspirin if they want to do surgery.