Evidence map›Paper›PMID 37295198›Full record

ArticleClinical neurology and neurosurgery2023

Venous thromboembolism in aneurysmal subarachnoid hemorrhage: Risk factors and timing of chemoprophylaxis.

Collin B Kilgore, Sumil K Nair, Kathleen R Ran, Justin M Caplan, Christopher M Jackson, L Fernando Gonzalez, Judy Huang, Rafael J Tamargo, Risheng Xu

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

Article in Clinical neurology and neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. 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

9 authors at 1 institution in 1 country.

Collin B KilgoreDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sumil K NairDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kathleen R RanDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Justin M CaplanDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher M JacksonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
L Fernando GonzalezDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Judy HuangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rafael J TamargoDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Risheng XuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: rxu4@jhmi.edu.
Johns Hopkins University · US

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007309 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI COX, ANDREA L · 1985 to 2019
$43.2M
Medical Scientist Training ProgramT32GM136577 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI ANDREA L COX · 2020 to 2026
$13.4M
NIGMS NIH HHS T32 GM007309NIGMS NIH HHS T32 GM136577
6 · The paper itself

Abstract

introductionVenous thromboembolism (VTE) is a significant contributor to morbidity and mortality among patients recovering from aneurysmal subarachnoid hemorrhage (aSAH). Prophylactic heparin reduces the risk of VTE, but the optimal timing for its initiation among aSAH patients remains unclear.

objectiveTo conduct a retrospective study assessing risk factors for VTE and optimal timing of chemoprophylaxis in patients treated for aSAH.

methodsFrom 2016-2020, 194 adult patients were treated for aSAH at our institution. Patient demographics, clinical diagnoses, complications, pharmacologic interventions, and outcomes were recorded. Risk factors for symptomatic VTE (sVTE) were analyzed via Chi-squared, univariate, and multivariate regression.

resultsIn total 33 patients presented with sVTE (25 DVT, 14 PE). Patients with sVTE had longer hospital stays (p < 0.01) and worse outcomes at one-month (p < 0.01) and three-month follow-up (p = 0.02). Univariate predictors of sVTE included male sex (p = 0.03), Hunt Hess score (p = 0.01), Glasgow Coma scale (p = 0.02), intracranial hemorrhage (p = 0.03), hydrocephalus requiring external ventricular drain (EVD) placement (p < 0.01), and mechanical ventilation (p < 0.01). Only hydrocephalus requiring EVD (p = 0.01) and ventilator use (p = 0.02) remained significant upon multivariate analysis. Patients with delayed heparin introduction were significantly more likely to sustain sVTE on univariate analysis (p = 0.02) with a trend-level significance on multivariate analysis (p = 0.07).

conclusionsPatients with aSAH are more likely to develop sVTE following use of perioperative EVD or mechanical ventilation. sVTE leads to longer hospital stays and worse outcomes among patients treated for aSAH. Delayed heparin initiation increases the risk of sVTE. Our results may help guide surgical decision-making during recovery from aSAH and improve VTE-related postoperative outcomes.

Indexed as

HydrocephalusSubarachnoid HemorrhageVenous ThromboembolismAdultChemopreventionHeparinHumansMaleRetrospective StudiesRisk FactorsHeparinAneurysmal subarachnoid hemorrhageDeep vein thrombosisHeparinProphylaxisPulmonary embolismTiming

Identifiers

PMID37295198
PMCPMC11097649
OpenAlexW4379622435

What OpenQuestion holds

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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.