Evidence map›Paper›PMID 22315265›Full record

GuidelineChest2012

Prevention of VTE in orthopedic surgery patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Yngve Falck-Ytter, Charles W Francis, Norman A Johanson, Catherine Curley, Ola E Dahl, Sam Schulman, Thomas L Ortel, Stephen G Pauker, Clifford W Colwell

2 registry-linked trialsAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 817 papers, 27 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
817citing papers in PubMed, 27 pooled it
–field-weighted citation impact
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.

NCT05658042 unknown statusnot on this mapstarted 2022, after this paper: background citation

Therapeutic Drug Monitoring Combined With Quantitative Pharmacology for Dose Optimization of Rivaroxaban in Combination With Rifampicin in Patients With Periprosthetic Joint Infection

TypeobservationalSponsorThe Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical SchoolRan2022 to 2025Enrolled80ConditionsInfections
NCT06611319 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

ENhanced Recovery and ABbreviated LEngth of Anticoagulation for Thromboprophylaxis After Primary Hip Arthroplasty

TypeinterventionalSponsorProf. Stavros Konstantinides, MDRan2024 to 2027Enrolled2,932ConditionsHip Arthroplasty, Total, Prevention of Venous ThromboembolismArmsPrevention of Venous Thromboembolism, Placebo Oral Tablet
3 · Its place in the literature

Who cites it

817 citing papers in PubMed, 27 syntheses or guidelines pooled it.

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  11. Factors related to deep vein thrombosis as a complication of post-total hip arthroplasty patients: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
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757 more citing papers are in PubMed but not listed here.

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

9 authors.

Yngve Falck-YtterDepartment of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH. Electronic address: Yngve.Falck-Ytter@case.edu.
Charles W FrancisHematology/Oncology Unit, University of Rochester Medical Center, Rochester, NY.
Norman A JohansonDepartment of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, PA.
Catherine CurleyDivision of Hospital Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
Ola E DahlInnlandet Hospitals, Brumunddal, Norway; Thrombosis Research Institute, Chelsea, London, England.
Sam SchulmanDepartment of Medicine, Division of Hematology and Thromboembolism, McMaster University, Hamilton, ON, Canada.
Thomas L OrtelHemostasis and Thrombosis Center, Duke University Health System, Durham, NC.
Stephen G PaukerTufts Medical Center, Boston, MA.
Clifford W ColwellShiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA.

Funding

Antithrombotic Therapy and Prevention of Thrombosis: ACCP Evidence-Based ClinicalR13HL104758 · NHLBI · AMERICAN COLLEGE OF CHEST PHYSICIANS · PI LEWIS, SANDRA ZELMAN · 2010 to 2010
$11k
NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

backgroundVTE is a serious, but decreasing complication following major orthopedic surgery. This guideline focuses on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT.

methodsThe methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

resultsIn patients undergoing major orthopedic surgery, we recommend the use of one of the following rather than no antithrombotic prophylaxis: low-molecular-weight heparin; fondaparinux; dabigatran, apixaban, rivaroxaban (total hip arthroplasty or total knee arthroplasty but not hip fracture surgery); low-dose unfractionated heparin; adjusted-dose vitamin K antagonist; aspirin (all Grade 1B); or an intermittent pneumatic compression device (IPCD) (Grade 1C) for a minimum of 10 to 14 days. We suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives (Grade 2C/2B), and in patients receiving pharmacologic prophylaxis, we suggest adding an IPCD during the hospital stay (Grade 2C). We suggest extending thromboprophylaxis for up to 35 days (Grade 2B). In patients at increased bleeding risk, we suggest an IPCD or no prophylaxis (Grade 2C). In patients who decline injections, we recommend using apixaban or dabigatran (all Grade 1B). We suggest against using inferior vena cava filter placement for primary prevention in patients with contraindications to both pharmacologic and mechanical thromboprophylaxis (Grade 2C). We recommend against Doppler (or duplex) ultrasonography screening before hospital discharge (Grade 1B). For patients with isolated lower-extremity injuries requiring leg immobilization, we suggest no thromboprophylaxis (Grade 2B). For patients undergoing knee arthroscopy without a history of VTE, we suggest no thromboprophylaxis (Grade 2B).

conclusionsOptimal strategies for thromboprophylaxis after major orthopedic surgery include pharmacologic and mechanical approaches.

Indexed as

Evidence-Based MedicineOrthopedic ProceduresSocieties, MedicalCombined Modality TherapyDose-Response Relationship, DrugDrug Administration ScheduleFibrinolytic AgentsHemorrhageHumansIntermittent Pneumatic Compression DevicesPostoperative ComplicationsPulmonary EmbolismRisk FactorsVenous ThromboembolismFibrinolytic Agents

Identifiers

PMID22315265
PMCPMC3278063

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.