Incidence and risk factors for venous thromboembolism in patients with nonsurgical isolated lower limb injuries

Riou, Bruno; Rothmann, C.; Lecoules, N.; Bouvat, E.; Bosson, Jean‐Luc; Ravaud, Philippe; Samama, Charles Marc; Hamadouche, Moussa

doi:10.1016/j.ajem.2006.09.012

Cited by 61 publications

(94 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The following assumptions were made to calculate the number of patients to be included: for pain intensity, we assumed a one-sided alpha risk of 0.025, a beta risk of 0.15, a standard deviation (SD) of change from baseline of pain intensity of 1.5 points, and a noninferiority margin of 0.5 point between the two groups, which represents half of the margin (1.0) usually chosen in superiority trials comparing NSAIDs and a placebo [17]. For associated analgesic drug consumption (acetaminophen equivalent), we assumed a one-sided alpha risk of 0.025, a beta risk of 0.05, an SD of 3 g over 5 days, and a noninferiority margin of 1.5 g between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two doses of ketoprofen to treat pain: a double‐blind, randomized, noninferiority trial

Riou

Plaisance

Lecomte

et al. 2012

Fundamemntal Clinical Pharma

Self Cite

View full text Add to dashboard Cite

The aim of our study was to compare the efficacy and safety of two doses of ketoprofen (200 mg vs. 300 mg/day) in ambulatory emergency patients with pain related to traumatic and nontraumatic bone and joint diseases. We tested the hypothesis that the efficacy of the lower dose was not lower than that of the higher dose in a double‐blind, randomized, noninferiority trial. Patients included in the study were aged 18–65 years with closed benign trauma of the motor system or acute noninfectious rheumatologic conditions, with a resting pain intensity ≥3/10 on a numeric pain scale (NPS), requiring ketoprofen for 5 days. The main end‐point was based on two efficacy co‐criteria: (i) mean change from baseline of resting pain intensity at the end of the day over 5 days and (ii) total intake of concomitant analgesics. We included 409 patients: 200 in the 200‐mg group and 209 in the 300‐mg group. The mean change in pain intensity at rest (difference between groups: 0.0, 95% CI −0.4 to 0.4; P = 1.00) and in analgesic consumption (difference between groups: −0.6, 95% CI −1.9 to 0.6; P = 0.33) was not significantly different between the two groups, and the differences were lower than the predefined inferiority margins (0.5 and 1.5, respectively), thus demonstrating noninferiority. No significant difference was noted in the incidence of adverse events (21% vs. 20%, P = 0.71). The efficacy of the 200‐mg daily dose of ketoprofen in relieving pain in emergency cases was not inferior to that of the 300‐mg dose.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of two doses of ketoprofen to treat pain: a double‐blind, randomized, noninferiority trial

Riou

Plaisance

Lecomte

et al. 2012

Fundamemntal Clinical Pharma

Self Cite

View full text Add to dashboard Cite

show abstract

“…While not all studies were explicit about weight-bearing status, some indicated that patients were mobilized with crutches. A separate study that involved the use of ultrasound for the evaluation of 2761 patients who presented to the emergency room with below-the-knee injuries demonstrated an overall rate of DVT of 6.4%, with rigid immobilization being a significant risk factor (OR 5 2.70; 95% CI 5 1.66 to 4.38; p , 0.0001) 41 . The study also showed that non-weight-bearing status (OR 5 4.11; 95% CI 5 1.72 to 9.86; p 5 0.0015), an age of greater than fifty years (OR 5 3.14; 95% CI 5 2.27 to 4.33; p , 0.0001), and greater injury severity (OR 5 1.88; 95% CI 5 1.34 to 2.62; p 5 0.0002) correlated with an increased risk of DVT.…”

Section: Incidence and Risk Factorsmentioning

confidence: 99%

“…Proximal DVTs in the lower extremity often require treatment in order to prevent both postthrombotic syndrome and clinical PE 57 . Both of these sequelae, however, may be much less applicable to DVTs that are localized distal to the popliteal fossa, which represent the vast majority of DVTs affecting foot and ankle patients 41 . One study examining postthrombotic syndrome demonstrated that proximal location, and not thrombus size, underlay progression to postthrombotic syndrome 58 .…”

Section: Need For Treatmentmentioning

confidence: 99%

Venous Thromboembolic Disease in Foot and Ankle Surgery

Guss

DiGiovanni

2015

JBJS Rev

View full text Add to dashboard Cite

“…While the largest series suggest that symptomatic deep vein thrombosis rates are comparable with those associated with other foot and ankle injuries, multiple smaller series do raise some concern, especially about patients older than forty years of age and those unable to mobilize [49][50][51][52][53][54] . In addition, many deep vein thromboses after Achilles tendon rupture occur preoperatively, a finding buttressed by studies showing that below-the-knee immobilization of lower-limb injuries is associated with deep vein thrombosis rates ranging from 4% to 19% [55][56][57] . Thus, prophylactic anticoagulation should be considered for older patients with an Achilles tendon rupture, including those treated nonsurgically, as well as for patients with other known risk factors.…”

mentioning

confidence: 96%