Evidence map›Paper›PMID 35318594›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022

Early Versus Postoperative Chemical Thromboprophylaxis Is Associated with Increased Bleeding Risk Following Abdominal Visceral Resections: a Multicenter Cohort Study.

David S Liu, Ryan Newbold, Sean Stevens, Enoch Wong, Jonathan Fong, Krinal Mori, Darren J Wong, Anna Sonia Gill, Sharon Lee, Wael Jamel and 9 more

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

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% 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, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. 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

19 authors at 4 institutions in 1 country.

David S LiuDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia. liu.davidsh@gmail.com.
Ryan NewboldDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Sean StevensDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Enoch WongDepartment of Surgery, Box Hill Hospital, 8 Arnold Street, Box Hill, Victoria, 3128, Australia.
Jonathan FongDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Krinal MoriDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Darren J WongGeneral and Gastrointestinal Surgery Research Group, Austin Precinct, Department of Surgery, The University of Melbourne, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Anna Sonia GillDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Sharon LeeDepartment of Surgery, Northern Health, 185 Cooper Street, Epping, Victoria, 3076, Australia.
Wael JamelDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Amy CroweDepartment of Surgery, Box Hill Hospital, 8 Arnold Street, Box Hill, Victoria, 3128, Australia.
Tess HowardDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Anshini JainDepartment of Surgery, Box Hill Hospital, 8 Arnold Street, Box Hill, Victoria, 3128, Australia.
Pith Soh BehDepartment of Surgery, Northern Health, 185 Cooper Street, Epping, Victoria, 3076, Australia.
Maeve SlevinDepartment of Surgery, Northern Health, 185 Cooper Street, Epping, Victoria, 3076, Australia.
Nicola FlemingDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Simon BennetDivision of Surgery, Anaesthetics and Procedural Medicine, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Chi ChungDepartment of Surgery, Box Hill Hospital, 8 Arnold Street, Box Hill, Victoria, 3128, Australia.
VERITAS collaborative
Austin Health · AUBox Hill Hospital · AUNorthern Health · AUUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAbdominal visceral resections incur relatively higher rates of postoperative bleeding and venous thromboembolism (VTE). While guidelines recommend the use of perioperative chemical thromboprophylaxis, the most appropriate time for its initiation is unknown. Here, we investigated whether early (before skin closure) versus postoperative commencement of chemoprophylaxis affected VTE and bleeding rates following abdominal visceral resection.

methodsRetrospective review of all elective abdominal visceral resections undertaken between January 1, 2018, and June 30, 2019, across four tertiary-referral hospitals. Major bleeding was defined as the need for blood transfusion, reintervention, or > 20 g/L fall in hemoglobin from baseline. Clinical VTE was defined as imaging-proven symptomatic disease < 30 days post-surgery.

resultsA total of 945 cases were analyzed. Chemoprophylaxis was given early in 265 (28.0%) patients and postoperatively in 680 (72.0%) patients. Mean chemoprophylaxis exposure doses were similar between the two groups. Clinical VTE developed in 14 (1.5%) patients and was unrelated to chemoprophylaxis timing. Postoperative bleeding occurred in 71 (7.5%) patients, with 57 (80.3%) major bleeds, requiring blood transfusion in 48 (67.6%) cases and reintervention in 31 (43.7%) cases. Bleeding extended length-of-stay (median (IQR), 12 (7-27) versus 7 (5-11) days, p < 0.001). Importantly, compared to postoperative chemoprophylaxis, early administration significantly increased the risk of bleeding (10.6% versus 6.3%, RR 1.45, 95% CI 1.05-1.93, p = 0.038) and independently predicted its occurrence.

conclusionsThe risk of bleeding following elective abdominal visceral resections is substantial and is higher than the risk of clinical VTE. Compared with early chemoprophylaxis, postoperative initiation reduces bleeding risk without an increased risk of clinical VTE.

Indexed as

Venous ThromboembolismAnticoagulantsHumansPostoperative ComplicationsPostoperative HemorrhagePostoperative PeriodRetrospective StudiesAnticoagulantsChemoprophylaxisLaparotomyThromboembolismTiming

Identifiers

PMID35318594
PMCPMC9296430
OpenAlexW4220904739

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.