Evidence map›Paper›PMID 22285109›Full record

Trial reportThrombosis research2012

Prospective study of the frequency and outcomes of patients with suspected pulmonary embolism administered heparin prior to confirmatory imaging.

Jeffrey A Kline, Michael R Marchick, Christopher Kabrhel, D Mark Courtney

Abstract readControlled Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Thrombosis research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
  3. Addressing the rising trend of high-risk pulmonary embolism mortality: Clinical and research priorities.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Jeffrey A KlineEmergency Medicine Research, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28323-2861, USA. Jkline@carolinas.org
Michael R Marchick
Christopher Kabrhel
D Mark Courtney
Carolinas Medical Center · USHarvard University Press · USUniversity of Florida · US

Funding

UF Clinical and Translational Science AwardUL1TR000064 · NCATS · UNIVERSITY OF FLORIDA · PI NELSON, DAVID R · 2012 to 2014
$12.2M
Pretest Probability Assessment for Pulmonary EmbolismR42HL074415 · NHLBI · BREATHQUANT MEDICAL SYSTEMS, INC. · PI KLINE, JEFFREY A · 2004 to 2005
$1.1M
Surrogate markers for Severe Pulmonary EmbolismR01HL074384 · NHLBI · CAROLINAS MEDICAL CENTER · PI KLINE, JEFFREY A · 2003 to 2005
$1.1M
Pretest probability assesment and D-dimer testing for pulmonary embolismK23HL077404 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI COURTNEY, D. MARK · 2004 to 2008
$633k
Pretest Probability Assessment for Pulmonary EmbolismR41HL074415 · NHLBI · BREATHQUANT MEDICAL SYSTEMS, INC. · PI KLINE, JEFFREY A · 2003 to 2003
$106k
NCATS NIH HHS UL1 TR000064NHLBI NIH HHS K23 HL077404NHLBI NIH HHS K23HL077404NHLBI NIH HHS L30 HL081998NHLBI NIH HHS R01 HL074384NHLBI NIH HHS R41 HL074415NHLBI NIH HHS R41HL074415NHLBI NIH HHS R42 HL074415NHLBI NIH HHS R42HL074415
6 · The paper itself

Abstract

objectivesThe administration of empiric systemic anticoagulation (ESA) before confirmatory radiographic testing in patients with suspected pulmonary embolism (PE) may improve outcomes, but no data have been published regarding current practice. We describe the use of ESA in a large prospective cohort of emergency department (ED) patients and report the outcomes of those treated with ESA compared with patients not receiving ESA.

methods12-center, noninterventional study of ED patients who presented with symptoms concerning for PE. Clinical data including pretest probability and decision to start ESA were recorded at point of care by attending physicians. Patients were followed for adverse in-hospital outcomes and recurrence of venous thromboembolism.

resultsESA was initiated 342/7932 (4.3%) of enrolled patients, including 142/618 (23%) patients with high pretest probability. Patients receiving ESA had more abnormal vital signs and were more likely to have a history of venous thromboembolism than those who did not receive ESA. Overall, 481/7,932 (6.1%) had PE diagnosed, 72/481 (15.0%) with PE had ESA, and 72/342 (21%) of ESA patients had PE. Three patients (0.9%, 95%CI: 0.2-2.5%) who received ESA suffered hemorrhagic complications compared with 38 patients (0.5%, 95%CI: 0.4-0.7%) who did not receive ESA.

conclusionsIn this multicenter sample, ED physicians administered ESA to a small, generally more acutely ill subset of patients with high pretest probability of PE, and very few had hemorrhagic complications. ESA was not associated with any clear difference in outcomes. More study is needed to clarify the risk versus benefit of ESA.

Indexed as

AngiographyAnticoagulantsFemaleHeparinHumansMaleMiddle AgedPrevalencePulmonary EmbolismRisk AssessmentRisk FactorsTreatment OutcomeUnited StatesAnticoagulantsHeparin

Identifiers

PMID22285109
PMCPMC3307953
OpenAlexW2067611781

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.