Evidence map›Paper›PMID 32428998›Full record

ArticleJournal of thrombosis and haemostasis : JTH2020

Periprocedural bridging anticoagulation in patients with venous thromboembolism: A registry-based cohort study.

Geoffrey D Barnes, Yun Li, Xiaokui Gu, Brian Haymart, Eva Kline-Rogers, Mona A Ali, Jay Kozlowski, Gregory Krol, James B Froehlich, Scott Kaatz

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

Article in Journal of thrombosis and haemostasis : JTH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 23% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. 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

10 authors at 5 institutions in 1 country.

Geoffrey D BarnesDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0002-6532-8440
Yun LiSchool of Public Health, University of Michigan, Ann Arbor, MI, USA.
Xiaokui GuDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.
Brian HaymartDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.
Eva Kline-RogersDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.
Mona A AliDepartment of Pharmacy, Beaumont Hospital, Royal Oak, MI, USA.
Jay KozlowskiDepartment of Internal Medicine, Huron Valley Sinai Hospital, Commerce Township, MI, USA.
Gregory KrolDepartment of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.
James B FroehlichDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.
Scott KaatzDivision of Hospital Medicine, Henry Ford Hospital, Detroit, MI, USA.
University of Michigan · USBeaumont Hospital, Royal Oak · USHenry Ford Health System · USHenry Ford Hospital · USSinai Hospital · US

Funding

Developing an Implementation Strategy to Improve Peri-procedural Anticoagulation Management for Patients with Atrial FibrillationK01HL135392 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARNES, GEOFFREY DOUGLAS · 2017 to 2021
$842k
NHLBI NIH HHS K01 HL135392
6 · The paper itself

Abstract

backgroundUse of bridging anticoagulation increases a patient's bleeding risk without clear evidence of thrombotic prevention among warfarin-treated patients with atrial fibrillation. Contemporary use of bridging anticoagulation among warfarin-treated patients with venous thromboembolism (VTE) has not been studied.

methodsWe identified warfarin-treated patients with VTE who temporarily stopped warfarin for a surgical procedure between 2010 and 2018 at six health systems. Using the 2012 American College of Chest Physicians guideline, we assessed use of periprocedural bridging anticoagulation based on recurrent VTE risk. Recurrent VTE risk and 30-day outcomes (bleeding, thromboembolism, emergency department visit) were each assessed using logistic regression adjusted for multiple procedures per patient.

resultsDuring the study period, 789 warfarin-treated patients with VTE underwent 1529 procedures (median, 2; interquartile range, 1-4). Unadjusted use of bridging anticoagulation was more common in patients at high risk for VTE recurrence (99/171, 57.9%) than for patients at moderate (515/1078, 47.8%) or low risk of recurrence (134/280, 47.86%). Bridging anticoagulation use was higher in high-risk patients compared with low- or moderate-risk patients in both unadjusted (P = .013) and patient-level cluster-adjusted analyses (P = .031). Adherence to American College of Chest Physicians guidelines in high- and low-risk patients did not change during the study period (odds ratio, 0.98 per year; 95% confidence interval, 0.91-1.05). Adverse events were rare and not statistically different between the two treatment groups.

conclusionsBridging anticoagulation was commonly overused among low-risk patients and underused among high-risk patients treated with warfarin for VTE. Adverse events were rare and not different between the two treatment groups.

Indexed as

Venous ThromboembolismAnticoagulantsCohort StudiesHeparin, Low-Molecular-WeightHumansRegistriesRisk FactorsAnticoagulantsHeparin, Low-Molecular-Weightanticoagulationheparinlow-molecular-weightperioperativevenous thromboembolismwarfarin

Identifiers

PMID32428998
PMCPMC7415673
OpenAlexW3027826944

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.