Anticoagulation for perioperative thromboprophylaxis in people with cancer

Matar, Charbel F; Kahale, Lara A; Hakoum, Maram B; Tsolakian, Ibrahim G; Etxeandia‐Ikobaltzeta, Itziar; Yosuico, Victor E D; Terrenato, Irene; Sperati, Francesca; Barba, Maddalena; Akl, Elie A.

doi:10.1002/14651858.cd009447.pub3

Cited by 26 publications

(31 citation statements)

References 127 publications

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“…However, we observed no difference between groups with regard to serious bleeding events (LMWH 12.5% vs UFH 22.7%, P = .31). This mirrors the results of recent publications on the use of enoxaparin, including a Cochrane review on its perioperative use, showing a reduction of bleeding rates . Reduced bleeding rates add to a number of other well described benefits with the use of LMWH, such as reduced rates of heparin‐induced thrombocytopenia, reduced activation of thrombocytes and improved bioavailability, ease of administration as well as reduced need for laboratory monitoring …”

Section: Discussionsupporting

confidence: 73%

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

et al. 2020

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Extracorporeal membrane oxygenation (ECMO) is gaining importance in the perioperative management of lung transplant patients. To date, the ideal substance for anticoagulation of ECMO patients is still a matter of debate. In this study, we describe our experience with the use of low molecular weight heparin (LMWH) in comparison with unfractioned heparin (UFH) in lung transplant patients undergoing perioperative ECMO support. We retrospectively analyzed data from all lung transplant patients who underwent perioperative ECMO support at our institution between 2013 and 2017. Bleeding events served as primary outcome parameter. Secondary outcome parameters consisted of thromboembolic events. 102 patients were included in this study, of which 22 (21.6%) received UFH for anticoagulation, and 80 (78.4%) received LMWH. There was no difference between the two groups in regard to serious bleeding events (22.7% in the UFH group vs 12.5% in the LMWH group, P = .31). However, the proportion of patients experiencing thromboembolic events was significantly higher in the UFH group than in the LMWH group (50% vs 20%, P = .01). After adjusting for baseline differences between the two groups, we still observed a difference with respect to thromboembolic events. These data remain to be validated in future prospective, randomized trials.

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Section: Discussionsupporting

confidence: 73%

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

et al. 2020

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“…Prognostic factors for NLDVT were CVC presence and acute infection. The first finding is not surprising, given that CVCs are a well-known risk factor for thrombosis [ 2 , 33 ]. The latter is a new finding that needs confirmation in a follow-up study.…”

Section: Discussionmentioning

confidence: 99%

Incidence, prognostic factors, and outcomes of venous thromboembolism in critically ill patients: data from two prospective cohort studies

et al. 2021

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Background The objective of this study was to describe the prevalence, incidence, prognostic factors, and outcomes of venous thromboembolism in critically ill patients receiving contemporary thrombosis prophylaxis. Methods We conducted a pooled analysis of two prospective cohort studies. The outcomes of interest were in-hospital pulmonary embolism or lower extremity deep vein thrombosis (PE-LDVT), in-hospital nonleg deep vein thrombosis (NLDVT), and 90-day mortality. Multivariable logistic regression analysis was used to evaluate the association between predefined baseline prognostic factors and PE-LDVT or NLDVT. Cox regression analysis was used to evaluate the association between PE-LDVT or NLDVT and 90-day mortality. Results A total of 2208 patients were included. The prevalence of any venous thromboembolism during 3 months before ICU admission was 3.6% (95% CI 2.8–4.4%). Out of 2166 patients, 47 (2.2%; 95% CI 1.6–2.9%) developed PE-LDVT and 38 patients (1.8%; 95% CI 1.2–2.4%) developed NLDVT. Renal replacement therapy (OR 3.5 95% CI 1.4–8.6), respiratory failure (OR 2.0; 95% CI 1.1–3.8), and previous VTE (OR 3.6; 95% CI 1.7–7.7) were associated with PE-LDVT. Central venous catheters (OR 5.4; 95% CI 1.7–17.8) and infection (OR 2.2; 95% CI 1.1–4.3) were associated with NLDVT. Occurrence of PE-LDVT but not NLDVT was associated with increased 90-day mortality (HR 2.7; 95% CI 1.6–4.6, respectively, 0.92; 95% CI 0.41–2.1). Conclusion Thrombotic events are common in critically ill patients, both before and after ICU admittance. Development of PE-LDVT but not NLDVT was associated with increased mortality. Prognostic factors for developing PE-LDVT or NLDVT despite prophylaxis can be identified at ICU admission and may be used to select patients at higher risk in future randomized clinical trials. Trial registration NCT03773939.

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“…Several randomized studies and meta-analysis have demonstrated the benefit of pharmacologic prophylaxis with LMWH and UFH over no prophylaxis or placebo unless there is a contraindication [9].…”

Section: Prophylaxis Of Vte In Surgical Cancer Patientsmentioning

confidence: 99%

SEOM clinical guideline of venous thromboembolism (VTE) and cancer (2019)

et al. 2020

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In 2011, the Spanish Society of Medical Oncology (SEOM) first published a clinical guideline of venous thromboembolism (VTE) and cancer. This guideline was updated in 2014, and since then, multiple studies and clinical trials have changed the landscape of the treatment and prophylaxis of VTE in cancer patients. To incorporate the most recent evidence, including data from direct oral anticoagulants (DOACs) randomized clinical trials, SEOM presents a new update of the guideline.

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Anticoagulation for perioperative thromboprophylaxis in people with cancer

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 26 publications

References 127 publications

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

Incidence, prognostic factors, and outcomes of venous thromboembolism in critically ill patients: data from two prospective cohort studies

SEOM clinical guideline of venous thromboembolism (VTE) and cancer (2019)

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