Evidence map›Paper›PMID 29877590›Full record

ArticleBritish journal of clinical pharmacology2018

Incidence and risk factors of major bleeding following major orthopaedic surgery with fondaparinux thromboprophylaxis. A time-to-event analysis.

P J Zufferey, E Ollier, X Delavenne, S Laporte, P Mismetti, S B Duffull

Open access · bronzeAbstract readMulticenter Study
In one paragraph

Article in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 30% 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

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Venous thromboembolism in orthopedic surgery: Global guidelines.Acta orthopaedica et traumatologica turcica · 2023
    Review
  3. Article
  4. Article
  5. Review
  6. Perioperative Deep Vein Thrombosis in Elderly Patients with Lower Extremity Fracture: A Comprehensive Review of Anesthetic Management Strategies.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Review
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

6 authors at 2 institutions in 2 countries.

P J ZuffereySchool of Pharmacy, University of Otago, PO Box 56, Dunedin, New Zealand.ORCID 0000-0003-2899-1195
E OllierU1059, Dysfonction Vasculaire et Hémostase, INSERM, F-42023, Saint-Etienne, France.ORCID 0000-0001-6925-2941
X DelavenneU1059, Dysfonction Vasculaire et Hémostase, INSERM, F-42023, Saint-Etienne, France.ORCID 0000-0001-7134-0713
S LaporteU1059, Dysfonction Vasculaire et Hémostase, INSERM, F-42023, Saint-Etienne, France.
P MismettiU1059, Dysfonction Vasculaire et Hémostase, INSERM, F-42023, Saint-Etienne, France.
S B DuffullSchool of Pharmacy, University of Otago, PO Box 56, Dunedin, New Zealand.
Inserm · FRUniversity of Otago · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIncreased exposure to fondaparinux, as observed in patients with renal impairment, may increase bleeding risk. This study aims to determine the time course of major bleeding after major orthopaedic surgery, identify predictors of bleeding and simulate the effect of a reduced dose of fondaparinux on bleeding for patients with moderate renal impairment (creatinine clearance = 20-50 ml min

methodsData including fondaparinux anti-Xa activities from two multicentre prospective cohorts were used. In the first cohort, patients (n = 957) received fondaparinux 2.5 mg once a day. In the second, patients with moderate renal impairment (n = 436) received 1.5 mg once per day. The time-to-major bleeding after the end of surgery was modelled using a parametric survival analysis in NONMEM.

resultsThe observed rate of major bleeding up to day 11 was 5.2%. The time-to-event analysis indicated that the hazard of bleeding was highest in the first days following surgery and then remained low thereafter. Independent significant predictors of an increased hazard of major bleeding were male sex, lower body weight and increased drug exposure. Simulated rates of major bleeding up to day 11 in patients with moderate renal impairment were 6.5% with fondaparinux 2.5 mg once daily and 3.8% with fondaparinux 1.5 mg once daily.

conclusionThe hazard of major bleeding is highest in the first postoperative days and increases with fondaparinux exposure. To reduce the risk of bleeding in patients with moderate renal impairment, this study supports the use of a lower dose of fondaparinux 1.5 mg once daily.

Indexed as

AdultAgedAged, 80 and overCreatinineDose-Response Relationship, DrugFactor Xa InhibitorsFemaleFollow-Up StudiesFondaparinuxGlomerular Filtration RateHumansIncidenceKidneyMaleMiddle AgedOrthopedic ProceduresCreatinineFactor Xa InhibitorsFondaparinuxfondaparinuxhaemorrhageorthopaedicssurvival analysisvenous thromboembolism/*prevention & control

Identifiers

PMID29877590
PMCPMC6138479
OpenAlexW2807541466

What OpenQuestion holds

Textmetadata
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.