Evidence map›Paper›PMID 31900592›Full record

ArticlePediatric surgery international2020

Pediatric trauma venous thromboembolism prediction algorithm outperforms current anticoagulation prophylaxis guidelines: a pilot study.

Aaron J Cunningham, Elizabeth Dewey, Saunders Lin, Kristina M Haley, Erin C Burns, Christopher R Connelly, Lori Moss, Katie Downie, Nicholas A Hamilton, Sanjay Krishnaswami and 2 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric surgery international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.1field-weighted citation impact, top 9% 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

7 citing papers in PubMed, 21 citations in OpenAlex.

  1. Trial
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  6. Venous thromboembolism prophylaxis after pediatric trauma.Pediatric surgery international · 2021
    Review
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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

12 authors at 3 institutions in 1 country.

Aaron J CunninghamDepartment of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., CDW7, Portland, OR, 97239, USA. cunninaa@ohsu.edu.ORCID http://orcid.org/0000-0003-0395-1461
Elizabeth DeweyDepartment of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., CDW7, Portland, OR, 97239, USA.
Saunders LinDepartment of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., CDW7, Portland, OR, 97239, USA.
Kristina M HaleyDivision of Hematology and Oncology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA.
Erin C BurnsDivision of Critical Care, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA.
Christopher R ConnellySection of Transplantation Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA.
Lori MossDoernbecher Children's Hospital, Oregon Health and Science University, Portland, OR, USA.
Katie DownieRandall Children's Hospital at Legacy Emanuel, Portland, OR, USA.
Nicholas A HamiltonDivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA.
Sanjay KrishnaswamiDivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA.
Martin A SchreiberDivision of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA.
Mubeen A JafriDivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA.
Oregon Health & Science University · USMichigan Medicine · USRandall Children's Hospital at Legacy Emanuel · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVenous thromboembolism (VTE) in injured children is rare, but sequelae can be morbid and life-threatening. Recent trauma society guidelines suggesting that all children over 15 years old should receive thromboprophylaxis may result in overtreatment. We sought to evaluate the efficacy of a previously published VTE prediction algorithm and compare it to current recommendations.

methodsTwo institutional trauma registries were queried for all pediatric (age < 18 years) patients admitted from 2007 to 2018. Clinical data were applied to the algorithm and the area under the receiver operating characteristic (AUROC) curve was calculated to test algorithm efficacy.

resultsA retrospective review identified 8271 patients with 30 episodes of VTE (0.36%). The VTE prediction algorithm classified 51 (0.6%) as high risk (> 5% risk), 322 (3.9%) as moderate risk (1-5% risk) and 7898 (95.5%) as low risk (< 1% risk). AUROC was 0.93 (95% CI 0.89-0.97). In our population, prophylaxis of the 'moderate-' and 'high-risk' cohorts would outperform the sensitivity (60% vs. 53%) and specificity (96% vs. 77%) of current guidelines while anticoagulating substantially fewer patients (373 vs. 1935, p < 0.001).

conclusionA VTE prediction algorithm using clinical variables can identify injured children at risk for venous thromboembolic disease with more discrimination than current guidelines. Prospective studies are needed to investigate the validity of this model. LEVEL OF EVIDENCE: III-Clinical decision rule evaluated in a single population.

Indexed as

AlgorithmsPractice Guidelines as TopicRegistriesAdolescentAnticoagulantsChildChild, PreschoolFemaleHospitalizationHumansInfantInfant, NewbornMalePilot ProjectsProspective StudiesRisk FactorsAnticoagulantsGuidelinesPediatric traumaThromboprophylaxisVenous thromboembolism

Identifiers

PMID31900592
PMCPMC7223182
OpenAlexW2997204057

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.