Evidence map›Paper›PMID 38548323›Full record

ArticleJournal of neurology, neurosurgery, and psychiatry2024

Venous thromboembolism risk in amyotrophic lateral sclerosis: a hospital record-linkage study.

Raph Goldacre, Michael Trubshaw, Eva J A Morris, Kevin Talbot, Michael J Goldacre, Alexander Guy Thompson, Martin R Turner

Abstract read
In one paragraph

Article in Journal of neurology, neurosurgery, and psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
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

7 authors.

Raph Goldacre *Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Michael Trubshaw *Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0002-4848-6156
Eva J A MorrisBig Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Kevin TalbotNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0001-5490-1697
Michael J GoldacreBig Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Alexander Guy ThompsonNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0003-1063-3277
Martin R TurnerNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK martin.turner@ndcn.ox.ac.uk.ORCID 0000-0003-0267-3180

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVenous thromboembolism (VTE) can occur in amyotrophic lateral sclerosis (ALS) and pulmonary embolism causes death in a minority of cases. The benefits of preventing VTE must be weighed against the risks. An accurate estimate of the incidence of VTE in ALS is crucial to assessing this balance.

methodsThis retrospective record-linkage cohort study derived data from the Hospital Episode Statistics database, covering admissions to England's hospitals from 1 April 2003 to 31 December 2019 and included 21 163 patients with ALS and 17 425 337 controls. Follow-up began at index admission and ended at VTE admission, death or 2 years (whichever came sooner). Adjusted HRs (aHRs) for VTE were calculated, controlling for confounders.

resultsThe incidence of VTE in the ALS cohort was 18.8/1000 person-years. The relative risk of VTE in ALS was significantly greater than in controls (aHR 2.7, 95% CI 2.4 to 3.0). The relative risk of VTE in patients with ALS under 65 years was five times higher than controls (aHR 5.34, 95% CI 4.6 to 6.2), and higher than that of patients over 65 years compared with controls (aHR 1.86, 95% CI 1.62 to 2.12).

conclusionsPatients with ALS are at a higher risk of developing VTE, but this is similar in magnitude to that reported in other chronic neurological conditions associated with immobility, such as multiple sclerosis, which do not routinely receive VTE prophylaxis. Those with ALS below the median age of symptom onset have a notably higher relative risk. A reappraisal of the case for routine antithrombotic therapy in those diagnosed with ALS now requires a randomised controlled trial.

Indexed as

Amyotrophic Lateral SclerosisVenous ThromboembolismAdultAgedAged, 80 and overCase-Control StudiesEnglandFemaleHumansIncidenceMaleMedical Record LinkageMiddle AgedPulmonary EmbolismRetrospective StudiesRisk FactorsEPIDEMIOLOGYMOTOR NEURON DISEASE

Identifiers

PMID38548323
PMCPMC11420722

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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.