Evidence map›Paper›PMID 37551583›Full record

SynthesisAnnals of surgery2024

Systematic Reviews and Meta-analyses of the Procedure-specific Risks of Thrombosis and Bleeding in General Abdominal, Colorectal, Upper Gastrointestinal, and Hepatopancreatobiliary Surgery.

Lauri I Lavikainen, Gordon H Guyatt, Ville J Sallinen, Paul J Karanicolas, Rachel J Couban, Tino Singh, Yung Lee, Jaana Elberkennou, Riikka Aaltonen, Kaisa Ahopelto and 29 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
8.6field-weighted citation impact, top 2% 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

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

39 authors at 20 institutions in 12 countries.

Lauri I LavikainenFaculty of Medicine, University of Helsinki, Helsinki, Finland.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Ville J SallinenDepartment of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Paul J KaranicolasDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Rachel J CoubanDepartment of Anesthesia, McMaster University, Hamilton, ON, Canada.
Tino SinghFaculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Yung LeeDepartment of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
Jaana ElberkennouDepartment of Surgery, Vaasa Central Hospital, Vaasa, Finland.
Riikka AaltonenDepartment of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.
Kaisa AhopeltoDepartment of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Ines Beilmann-LehtonenDepartment of Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Marco H BlankerDepartment of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jovita L CárdenasDirection of Health Technologies Assessment, National Center for Health Technology Excellence (CENETEC), Mexico City, Mexico.
Rufus CartwrightDepartments of Gynecology and Gender Affirmation Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK.
Samantha CraigieDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
P J DevereauxDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Herney A Garcia-PerdomoDepartment of Surgery, Division of Urology, School of Medicine, Universidad del Valle, Cali, Colombia.
Fang Zhou GeDepartment of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Huda A GomaaDepartment of Biostatistics, High Institute of Public Health, Alexandria University, Egypt.
Alex L E HalmeFaculty of Medicine, University of Helsinki, Helsinki, Finland.
Jari HaukkaHealth Sciences, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Päivi K KarjalainenDepartment of Obstetrics and Gynecology, Hospital Nova of Central Finland, Jyväskylä, Finland.
Tuomas P KilpeläinenDepartment of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Antti J KiveläDepartment of Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Hanna LampelaDepartment of Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Anne K MattilaDepartment of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
Borna Tadayon NajafabadiDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Taina P NykänenDepartment of Surgery, Hyvinkää Hospital, Hyvinkää, Finland.
Sanjay PandanaboyanaDepartment of HPB and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, UK.
Negar PourjamalFaculty of Medicine, University of Helsinki, Helsinki, Finland.
Chathura B B RatnayakeDepartment of Surgery, The University of Auckland, Auckland, New Zealand.
Aleksi RaudasojaFaculty of Medicine, University of Helsinki, Helsinki, Finland.
Robin W M VernooijJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Philippe D VioletteDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Yuting WangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Yingqi XiaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Liang YaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Kari A O TikkinenFaculty of Medicine, University of Helsinki, Helsinki, Finland.
ROTBIGGS Investigators
University of Helsinki · FIImpact · CACentral Finland Health Care District · FIMcMaster University · CASichuan University · CNFreeman Hospital · GBHyvinkää Hospital · FIOutcomes Research Consortium · USPhilips (Finland) · FISunnybrook Health Science Centre · CATanta University Hospital · EGTechnologies pour la Santé · FRUniversidad del Valle · COUniversity Medical Center Groningen · NLUniversity of Auckland · NZUniversity of Eastern Finland · FIUniversity of Toronto · CAUniversity of Turku · FIUtrecht University · NLVaasa Central Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo provide procedure-specific estimates of symptomatic venous thromboembolism (VTE) and major bleeding after abdominal surgery.

backgroundThe use of pharmacological thromboprophylaxis represents a trade-off that depends on VTE and bleeding risks that vary between procedures; their magnitude remains uncertain.

methodsWe identified observational studies reporting procedure-specific risks of symptomatic VTE or major bleeding after abdominal surgery, adjusted the reported estimates for thromboprophylaxis and length of follow-up, and estimated cumulative incidence at 4 weeks postsurgery, stratified by VTE risk groups, and rated evidence certainty.

resultsAfter eligibility screening, 285 studies (8,048,635 patients) reporting on 40 general abdominal, 36 colorectal, 15 upper gastrointestinal, and 24 hepatopancreatobiliary surgery procedures proved eligible. Evidence certainty proved generally moderate or low for VTE and low or very low for bleeding requiring reintervention. The risk of VTE varied substantially among procedures: in general abdominal surgery from a median of <0.1% in laparoscopic cholecystectomy to a median of 3.7% in open small bowel resection, in colorectal from 0.3% in minimally invasive sigmoid colectomy to 10.0% in emergency open total proctocolectomy, and in upper gastrointestinal/hepatopancreatobiliary from 0.2% in laparoscopic sleeve gastrectomy to 6.8% in open distal pancreatectomy for cancer.

conclusionsVTE thromboprophylaxis provides net benefit through VTE reduction with a small increase in bleeding in some procedures (eg, open colectomy and open pancreaticoduodenectomy), whereas the opposite is true in others (eg, laparoscopic cholecystectomy and elective groin hernia repairs). In many procedures, thromboembolism and bleeding risks are similar, and decisions depend on individual risk prediction and values and preferences regarding VTE and bleeding.

Indexed as

Colorectal NeoplasmsThrombosisVenous ThromboembolismAnticoagulantsHemorrhageHumansPostoperative ComplicationsAnticoagulants

Identifiers

PMID37551583
PMCPMC10782937
OpenAlexW4385663843

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.