Venous Thromboembolism in Neurocritical Care Patients

Viarasilpa, Tanuwong; Panyavachiraporn, Nicha; Jordan, John R.; Marashi, Seyed Mani; Harn, Meredith Van; Akioyamen, Noel O; Kowalski, Robert G.; Mayer, Stephan A.

doi:10.1177/0885066619841547

Cited by 11 publications

(8 citation statements)

References 66 publications

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“…Major surgery, traumatic injury/fracture, hospitalization, and prior VTE are among the strongest predictors for developing VTE (7)(8)(9). Patients with hip fractures are at a particularly high risk, due to prolonged non-weight bearing and extensive tissue damage (10)(11)(12)(13)(14). While not indicated in all trauma patients, pharmacologic thromboprophylaxis lowers the risk of fatal PE in hip fracture patients (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Equivalence of DOACS and LMWH for thromboprophylaxis after hip fracture surgery: Systematic review and meta-analysis

Nederpelt¹,

Bijman²,

Krijnen³

et al. 2022

Injury

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Section: Introductionmentioning

confidence: 99%

Equivalence of DOACS and LMWH for thromboprophylaxis after hip fracture surgery: Systematic review and meta-analysis

Nederpelt¹,

Bijman²,

Krijnen³

et al. 2022

Injury

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“…Studies were predominantly observational cohorts from North America involving mixed medicalsurgical ICU patient populations. There was one study (198 patients) involving a specialized cardiac ICU (36), three studies (3,317 patients) involving neurologic ICUs (37)(38)(39), and four studies (1,101 patients) involving trauma ICUs (40)(41)(42)(43). Most studies evaluated any symptomatic VTE (DVT or PE) as the primary outcome, though some studies evaluated only DVT (2,(44)(45)(46)(47), only PE (6,36,37,40,(48)(49)(50), or only CVC-associated DVT (39,51).…”

Section: Search Resultsmentioning

confidence: 99%

Prognostic Factors Associated With Development of Venous Thromboembolism in Critically Ill Patients—A Systematic Review and Meta-Analysis

Tran

Fernando

Rochwerg

et al. 2021

Critical Care Medicine

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OBJECTIVE: To identify prognostic factors for the development of venous thromboembolism in the ICU. DATA SOURCES: We searched MEDLINE, EMBASE, and Cochrane CENTRAL from inception to March 1, 2021. STUDY SELECTION: We included English-language studies describing prognostic factors associated with the development of venous thromboembolism among critically ill patients. DATA EXTRACTION: Two authors performed data extraction and risk-of-bias assessment. We pooled adjusted odds ratios and adjusted hazard ratios for prognostic factors using random-effects model. We assessed risk of bias using the Quality in Prognosis Studies tool and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach. DATA SYNTHESIS: We included 39 observational cohort studies involving 729,477 patients. Patient factors with high or moderate certainty of association with increased odds of venous thromboembolism include older age (adjusted odds ratio, 1.15; 95% CI, 1.02–1.29 per 10 yr), obesity (adjusted odds ratio, 1.25; 95% CI, 1.18–1.32), active malignancy (adjusted odds ratio, 1.70; 95% CI, 1.18–2.44), history of venous thromboembolism (adjusted odds ratio, 4.77; 95% CI, 3.42–6.65), and history of recent surgery (adjusted odds ratio, 1.77; 95% CI, 1.26–2.47). ICU-specific factors with high or moderate certainty of association with increased risk of venous thromboembolism include sepsis (adjusted odds ratio, 1.41; 95% CI, 1.12–1.78), lack of pharmacologic venous thromboembolism prophylaxis (adjusted odds ratio, 1.80; 95% CI, 1.14–2.84), central venous catheter (adjusted odds ratio, 2.93; 95% CI, 1.98–4.34), invasive mechanical ventilation (adjusted odds ratio, 1.74; 95% CI, 1.36–2.24), and use of vasoactive medication (adjusted odds ratio, 1.86; 95% CI, 1.23–2.81). CONCLUSIONS: This meta-analysis provides quantitative summaries of the association between patient-specific and ICU-related prognostic factors and the risk of venous thromboembolism in the ICU. These findings provide the foundation for the development of a venous thromboembolism risk stratification tool for critically ill patients.

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“… 22 , 23 CVC was proven to be an independent risk factor for VTE, and it has nothing to do with the location of CVC. 24 …”

Section: Discussionmentioning

confidence: 99%

Derivation and External Validation of a Risk Assessment Model of Venous Thromboembolism in Hospitalized Chinese Patients

Chen

Huang

Liu

et al. 2023

Clin Appl Thromb Hemost

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Aim To develop and validate a risk assessment model (RAM) of venous thromboembolism (VTE) in hospitalized Chinese patients. Methods We reviewed data from 300 patients with VTE and 300 non-VTE patients at Beijing Shijitan Hospital. The risk factors related to VTE were analyzed, and the VTE RAM (Shijitan (SJT) version) was developed according to the weight of each risk factor. A total of 407 patients with VTE and 533 non-VTE patients were enrolled for external validation. The sensitivity, specificity, Youden index, receiver operating curve (ROC), and area under the ROC curve (AUC) were used to evaluate the performance of VTE RAM (SJT version) compared with Caprini RAM and Padua RAM. Results The VTE RAM (SJT version) contained six risk factors (age >60 years, lower limb edema, chronic obstructive pulmonary disease (COPD), central venous catheterization (CVC), VTE history, and D dimer). In the external validation group, for medical patients, the AUC value of SJT RAM (0.82 ± 0.03) is significantly higher than Caprini RAM (0.76 ± 0.04; P < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Caprini RAM ( P < 0.05), which means that the SJT RAM has a much better predictive value than Caprini RAM. While SJT RAM and Padua RAM have the similar predictive value for medical patients ( P > 0.05). For surgical patients, the AUC value of SJT RAM (0.72 ± 0.04) is significantly higher than the value of Padua RAM (0.66 ± 0.04; P < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Padua RAM ( P < 0.05), which shows that the VTE RAM has better predictive value than Padua RAM. While SJT RAM and Caprini RAM have the similar predictive value for surgical patients ( P > 0.05). Conclusion The SJT RAM derived from general hospitalized Chinese patients will be time-saving for physicians and has a better predictive ability for patients at risk of VTE.

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Venous Thromboembolism in Neurocritical Care Patients

Cited by 11 publications

References 66 publications

Equivalence of DOACS and LMWH for thromboprophylaxis after hip fracture surgery: Systematic review and meta-analysis

Equivalence of DOACS and LMWH for thromboprophylaxis after hip fracture surgery: Systematic review and meta-analysis

Prognostic Factors Associated With Development of Venous Thromboembolism in Critically Ill Patients—A Systematic Review and Meta-Analysis

Derivation and External Validation of a Risk Assessment Model of Venous Thromboembolism in Hospitalized Chinese Patients

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