Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis
Essentials Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options. We provide profiles of venous thromboembolism and hemorrhage risk for 12 options. Direct oral Xa inhibitors had a favorable profile compared with low‐molecular‐weight heparin. Other options did...
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| Veröffentlicht in: | Journal of thrombosis and haemostasis 2017-02, Vol.15 (2), p.284-294 |
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| creator | Kapoor, A. Ellis, A. Shaffer, N. Gurwitz, J. Chandramohan, A. Saulino, J. Ishak, A. Okubanjo, T. Michota, F. Hylek, E. Trikalinos, T. A |
| description | Essentials
Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options.
We provide profiles of venous thromboembolism and hemorrhage risk for 12 options.
Direct oral Xa inhibitors had a favorable profile compared with low‐molecular‐weight heparin.
Other options did not have favorable profiles compared with low‐molecular‐weight heparin.
Summary
Background
There are numerous trials and several meta‐analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR). None have included simultaneous comparison of new with older options.
Objective
To measure simultaneously the relative risk of VTE and hemorrhage for 12 prophylaxis options.
Methods
We ed VTE and hemorrhage information from randomized controlled trials published between January 1990 and June 2016 comparing 12 prophylaxis options. We then constructed networks to compute the relative risk for each option, relative to once‐daily dosing with low‐molecular‐weight heparin (LMWH) Low.
Results
Main: Relative to LMWH Low, direct oral Xa inhibitors had the lowest risk of total deep vein thrombosis (DVT)‐asymptomatic and symptomatic‐ (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.35–0.57), translating to 53–139 fewer DVTs per 1000 patients. Vitamin K antagonists (VKAs) titrated to International Normalized Ratio [INR] 2–3 predicted 56% more DVT events (OR, 1.56; 95% CI, 1.14–2.14). Aspirin performed similarly (OR, 0.80; 95% CI, 0.34–1.86), although small numbers prohibit firm conclusions. Direct oral Xa inhibitors did not lead to significantly more bleeding (OR, 1.21; 95% CI, 0.79‐1.90). Secondary: Relative to LMWH Low, direct oral Xa inhibitors prevented 4‐fold more symptomatic DVTs (OR, 0.25; 95% CI, 0.13–0.47).
Conclusions
Relative to LMWH Low, direct oral Xa inhibitors had a more favorable profile of VTE and hemorrhage risk, whereas VKAs had a less favorable profile. The profile of other agents was not more or less favorable. Clinicians should consider these profiles when selecting prophylaxis options. |
| doi_str_mv | 10.1111/jth.13566 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5305416</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2291824586</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4716-b2657b316fcc9848236e6b79712a3d48e190e84eac4d50f1b607b3ca40c1802f3</originalsourceid><addsrcrecordid>eNp9kc1qFTEYhgdRbK0uvAEJuHJx2vxMMhkXQjmoVQpu6jpkMl_O5HQmGZNM69l5CV6AV-eVmHraogsNhLyQh4fv462q5wQfk3JOtnk4JowL8aA6JJzJVSOZeHiXW8YOqicpbTEmLaf4cXVAJcFUEH5Y_ViHadZRZ3cFCKwFc5M8pISCRSWFJaE8xDB1AcodXZrQHMM87Eb91RVqzi74hGyIhQM0FxX4jBbfQ9wE5zcoh6xHNLgZad-jSw-AIsyjNjAV8jXSyEO-DvESTZD1z2_ftdfjLrn0tHpk9Zjg2e17VH1-9_ZifbY6__T-w_r0fGXqhohVRwVvOkaENaaVtaRMgOiatiFUs76WQFoMsgZt6p5jSzqBC250jQ2RmFp2VL3Ze-elm6A3ZaqoRzVHN-m4U0E79fePd4PahCvFGeY1EUXw8lYQw5cFUlbbsMSyRVKUtkTSmsv_UkSKphalFFqoV3vKxJBSBHs_B8Hqpm5V6la_6y7siz8Hvyfv-i3AyR64diPs_m1SHy_O9spfbia5sw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1867461022</pqid></control><display><type>article</type><title>Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Kapoor, A. ; Ellis, A. ; Shaffer, N. ; Gurwitz, J. ; Chandramohan, A. ; Saulino, J. ; Ishak, A. ; Okubanjo, T. ; Michota, F. ; Hylek, E. ; Trikalinos, T. A</creator><creatorcontrib>Kapoor, A. ; Ellis, A. ; Shaffer, N. ; Gurwitz, J. ; Chandramohan, A. ; Saulino, J. ; Ishak, A. ; Okubanjo, T. ; Michota, F. ; Hylek, E. ; Trikalinos, T. A</creatorcontrib><description>Essentials
Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options.
We provide profiles of venous thromboembolism and hemorrhage risk for 12 options.
Direct oral Xa inhibitors had a favorable profile compared with low‐molecular‐weight heparin.
Other options did not have favorable profiles compared with low‐molecular‐weight heparin.
Summary
Background
There are numerous trials and several meta‐analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR). None have included simultaneous comparison of new with older options.
Objective
To measure simultaneously the relative risk of VTE and hemorrhage for 12 prophylaxis options.
Methods
We ed VTE and hemorrhage information from randomized controlled trials published between January 1990 and June 2016 comparing 12 prophylaxis options. We then constructed networks to compute the relative risk for each option, relative to once‐daily dosing with low‐molecular‐weight heparin (LMWH) Low.
Results
Main: Relative to LMWH Low, direct oral Xa inhibitors had the lowest risk of total deep vein thrombosis (DVT)‐asymptomatic and symptomatic‐ (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.35–0.57), translating to 53–139 fewer DVTs per 1000 patients. Vitamin K antagonists (VKAs) titrated to International Normalized Ratio [INR] 2–3 predicted 56% more DVT events (OR, 1.56; 95% CI, 1.14–2.14). Aspirin performed similarly (OR, 0.80; 95% CI, 0.34–1.86), although small numbers prohibit firm conclusions. Direct oral Xa inhibitors did not lead to significantly more bleeding (OR, 1.21; 95% CI, 0.79‐1.90). Secondary: Relative to LMWH Low, direct oral Xa inhibitors prevented 4‐fold more symptomatic DVTs (OR, 0.25; 95% CI, 0.13–0.47).
Conclusions
Relative to LMWH Low, direct oral Xa inhibitors had a more favorable profile of VTE and hemorrhage risk, whereas VKAs had a less favorable profile. The profile of other agents was not more or less favorable. Clinicians should consider these profiles when selecting prophylaxis options.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1111/jth.13566</identifier><identifier>PMID: 28102615</identifier><language>eng</language><publisher>England: Elsevier Limited</publisher><subject>Administration, Oral ; Aged ; Antagonists ; Anticoagulants - therapeutic use ; anticoagulation ; Arthroplasty, Replacement, Hip - methods ; Arthroplasty, Replacement, Knee - methods ; Aspirin ; Clinical trials ; Coagulation ; Comparative Effectiveness Research ; Factor Xa Inhibitors - therapeutic use ; Female ; Health risk assessment ; Hemorrhage ; Hemorrhage - chemically induced ; Hemorrhage - drug therapy ; Heparin ; Heparin, Low-Molecular-Weight - therapeutic use ; Hip ; Humans ; Knee ; Male ; Meta-analysis ; Middle Aged ; Network Meta-Analysis ; Odds Ratio ; Patient Safety ; Prophylaxis ; Risk ; Thromboembolism ; Thromboembolism - drug therapy ; Thrombosis ; total hip replacement ; total knee replacement ; venous thromboembolism ; Venous Thromboembolism - chemically induced ; Venous Thromboembolism - prevention & control ; Venous Thrombosis - drug therapy ; Vitamin K</subject><ispartof>Journal of thrombosis and haemostasis, 2017-02, Vol.15 (2), p.284-294</ispartof><rights>2016 International Society on Thrombosis and Haemostasis</rights><rights>2016 International Society on Thrombosis and Haemostasis.</rights><rights>Copyright © 2017 International Society on Thrombosis and Haemostasis</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4716-b2657b316fcc9848236e6b79712a3d48e190e84eac4d50f1b607b3ca40c1802f3</citedby><cites>FETCH-LOGICAL-c4716-b2657b316fcc9848236e6b79712a3d48e190e84eac4d50f1b607b3ca40c1802f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28102615$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kapoor, A.</creatorcontrib><creatorcontrib>Ellis, A.</creatorcontrib><creatorcontrib>Shaffer, N.</creatorcontrib><creatorcontrib>Gurwitz, J.</creatorcontrib><creatorcontrib>Chandramohan, A.</creatorcontrib><creatorcontrib>Saulino, J.</creatorcontrib><creatorcontrib>Ishak, A.</creatorcontrib><creatorcontrib>Okubanjo, T.</creatorcontrib><creatorcontrib>Michota, F.</creatorcontrib><creatorcontrib>Hylek, E.</creatorcontrib><creatorcontrib>Trikalinos, T. A</creatorcontrib><title>Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Essentials
Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options.
We provide profiles of venous thromboembolism and hemorrhage risk for 12 options.
Direct oral Xa inhibitors had a favorable profile compared with low‐molecular‐weight heparin.
Other options did not have favorable profiles compared with low‐molecular‐weight heparin.
Summary
Background
There are numerous trials and several meta‐analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR). None have included simultaneous comparison of new with older options.
Objective
To measure simultaneously the relative risk of VTE and hemorrhage for 12 prophylaxis options.
Methods
We ed VTE and hemorrhage information from randomized controlled trials published between January 1990 and June 2016 comparing 12 prophylaxis options. We then constructed networks to compute the relative risk for each option, relative to once‐daily dosing with low‐molecular‐weight heparin (LMWH) Low.
Results
Main: Relative to LMWH Low, direct oral Xa inhibitors had the lowest risk of total deep vein thrombosis (DVT)‐asymptomatic and symptomatic‐ (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.35–0.57), translating to 53–139 fewer DVTs per 1000 patients. Vitamin K antagonists (VKAs) titrated to International Normalized Ratio [INR] 2–3 predicted 56% more DVT events (OR, 1.56; 95% CI, 1.14–2.14). Aspirin performed similarly (OR, 0.80; 95% CI, 0.34–1.86), although small numbers prohibit firm conclusions. Direct oral Xa inhibitors did not lead to significantly more bleeding (OR, 1.21; 95% CI, 0.79‐1.90). Secondary: Relative to LMWH Low, direct oral Xa inhibitors prevented 4‐fold more symptomatic DVTs (OR, 0.25; 95% CI, 0.13–0.47).
Conclusions
Relative to LMWH Low, direct oral Xa inhibitors had a more favorable profile of VTE and hemorrhage risk, whereas VKAs had a less favorable profile. The profile of other agents was not more or less favorable. Clinicians should consider these profiles when selecting prophylaxis options.</description><subject>Administration, Oral</subject><subject>Aged</subject><subject>Antagonists</subject><subject>Anticoagulants - therapeutic use</subject><subject>anticoagulation</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Aspirin</subject><subject>Clinical trials</subject><subject>Coagulation</subject><subject>Comparative Effectiveness Research</subject><subject>Factor Xa Inhibitors - therapeutic use</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Hemorrhage</subject><subject>Hemorrhage - chemically induced</subject><subject>Hemorrhage - drug therapy</subject><subject>Heparin</subject><subject>Heparin, Low-Molecular-Weight - therapeutic use</subject><subject>Hip</subject><subject>Humans</subject><subject>Knee</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Network Meta-Analysis</subject><subject>Odds Ratio</subject><subject>Patient Safety</subject><subject>Prophylaxis</subject><subject>Risk</subject><subject>Thromboembolism</subject><subject>Thromboembolism - drug therapy</subject><subject>Thrombosis</subject><subject>total hip replacement</subject><subject>total knee replacement</subject><subject>venous thromboembolism</subject><subject>Venous Thromboembolism - chemically induced</subject><subject>Venous Thromboembolism - prevention & control</subject><subject>Venous Thrombosis - drug therapy</subject><subject>Vitamin K</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1qFTEYhgdRbK0uvAEJuHJx2vxMMhkXQjmoVQpu6jpkMl_O5HQmGZNM69l5CV6AV-eVmHraogsNhLyQh4fv462q5wQfk3JOtnk4JowL8aA6JJzJVSOZeHiXW8YOqicpbTEmLaf4cXVAJcFUEH5Y_ViHadZRZ3cFCKwFc5M8pISCRSWFJaE8xDB1AcodXZrQHMM87Eb91RVqzi74hGyIhQM0FxX4jBbfQ9wE5zcoh6xHNLgZad-jSw-AIsyjNjAV8jXSyEO-DvESTZD1z2_ftdfjLrn0tHpk9Zjg2e17VH1-9_ZifbY6__T-w_r0fGXqhohVRwVvOkaENaaVtaRMgOiatiFUs76WQFoMsgZt6p5jSzqBC250jQ2RmFp2VL3Ze-elm6A3ZaqoRzVHN-m4U0E79fePd4PahCvFGeY1EUXw8lYQw5cFUlbbsMSyRVKUtkTSmsv_UkSKphalFFqoV3vKxJBSBHs_B8Hqpm5V6la_6y7siz8Hvyfv-i3AyR64diPs_m1SHy_O9spfbia5sw</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Kapoor, A.</creator><creator>Ellis, A.</creator><creator>Shaffer, N.</creator><creator>Gurwitz, J.</creator><creator>Chandramohan, A.</creator><creator>Saulino, J.</creator><creator>Ishak, A.</creator><creator>Okubanjo, T.</creator><creator>Michota, F.</creator><creator>Hylek, E.</creator><creator>Trikalinos, T. A</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>5PM</scope></search><sort><creationdate>201702</creationdate><title>Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis</title><author>Kapoor, A. ; Ellis, A. ; Shaffer, N. ; Gurwitz, J. ; Chandramohan, A. ; Saulino, J. ; Ishak, A. ; Okubanjo, T. ; Michota, F. ; Hylek, E. ; Trikalinos, T. A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4716-b2657b316fcc9848236e6b79712a3d48e190e84eac4d50f1b607b3ca40c1802f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Administration, Oral</topic><topic>Aged</topic><topic>Antagonists</topic><topic>Anticoagulants - therapeutic use</topic><topic>anticoagulation</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Aspirin</topic><topic>Clinical trials</topic><topic>Coagulation</topic><topic>Comparative Effectiveness Research</topic><topic>Factor Xa Inhibitors - therapeutic use</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Hemorrhage</topic><topic>Hemorrhage - chemically induced</topic><topic>Hemorrhage - drug therapy</topic><topic>Heparin</topic><topic>Heparin, Low-Molecular-Weight - therapeutic use</topic><topic>Hip</topic><topic>Humans</topic><topic>Knee</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Network Meta-Analysis</topic><topic>Odds Ratio</topic><topic>Patient Safety</topic><topic>Prophylaxis</topic><topic>Risk</topic><topic>Thromboembolism</topic><topic>Thromboembolism - drug therapy</topic><topic>Thrombosis</topic><topic>total hip replacement</topic><topic>total knee replacement</topic><topic>venous thromboembolism</topic><topic>Venous Thromboembolism - chemically induced</topic><topic>Venous Thromboembolism - prevention & control</topic><topic>Venous Thrombosis - drug therapy</topic><topic>Vitamin K</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kapoor, A.</creatorcontrib><creatorcontrib>Ellis, A.</creatorcontrib><creatorcontrib>Shaffer, N.</creatorcontrib><creatorcontrib>Gurwitz, J.</creatorcontrib><creatorcontrib>Chandramohan, A.</creatorcontrib><creatorcontrib>Saulino, J.</creatorcontrib><creatorcontrib>Ishak, A.</creatorcontrib><creatorcontrib>Okubanjo, T.</creatorcontrib><creatorcontrib>Michota, F.</creatorcontrib><creatorcontrib>Hylek, E.</creatorcontrib><creatorcontrib>Trikalinos, T. A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kapoor, A.</au><au>Ellis, A.</au><au>Shaffer, N.</au><au>Gurwitz, J.</au><au>Chandramohan, A.</au><au>Saulino, J.</au><au>Ishak, A.</au><au>Okubanjo, T.</au><au>Michota, F.</au><au>Hylek, E.</au><au>Trikalinos, T. A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2017-02</date><risdate>2017</risdate><volume>15</volume><issue>2</issue><spage>284</spage><epage>294</epage><pages>284-294</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Essentials
Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options.
We provide profiles of venous thromboembolism and hemorrhage risk for 12 options.
Direct oral Xa inhibitors had a favorable profile compared with low‐molecular‐weight heparin.
Other options did not have favorable profiles compared with low‐molecular‐weight heparin.
Summary
Background
There are numerous trials and several meta‐analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR). None have included simultaneous comparison of new with older options.
Objective
To measure simultaneously the relative risk of VTE and hemorrhage for 12 prophylaxis options.
Methods
We ed VTE and hemorrhage information from randomized controlled trials published between January 1990 and June 2016 comparing 12 prophylaxis options. We then constructed networks to compute the relative risk for each option, relative to once‐daily dosing with low‐molecular‐weight heparin (LMWH) Low.
Results
Main: Relative to LMWH Low, direct oral Xa inhibitors had the lowest risk of total deep vein thrombosis (DVT)‐asymptomatic and symptomatic‐ (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.35–0.57), translating to 53–139 fewer DVTs per 1000 patients. Vitamin K antagonists (VKAs) titrated to International Normalized Ratio [INR] 2–3 predicted 56% more DVT events (OR, 1.56; 95% CI, 1.14–2.14). Aspirin performed similarly (OR, 0.80; 95% CI, 0.34–1.86), although small numbers prohibit firm conclusions. Direct oral Xa inhibitors did not lead to significantly more bleeding (OR, 1.21; 95% CI, 0.79‐1.90). Secondary: Relative to LMWH Low, direct oral Xa inhibitors prevented 4‐fold more symptomatic DVTs (OR, 0.25; 95% CI, 0.13–0.47).
Conclusions
Relative to LMWH Low, direct oral Xa inhibitors had a more favorable profile of VTE and hemorrhage risk, whereas VKAs had a less favorable profile. The profile of other agents was not more or less favorable. Clinicians should consider these profiles when selecting prophylaxis options.</abstract><cop>England</cop><pub>Elsevier Limited</pub><pmid>28102615</pmid><doi>10.1111/jth.13566</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1538-7933 |
| ispartof | Journal of thrombosis and haemostasis, 2017-02, Vol.15 (2), p.284-294 |
| issn | 1538-7933 1538-7836 1538-7836 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5305416 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Administration, Oral Aged Antagonists Anticoagulants - therapeutic use anticoagulation Arthroplasty, Replacement, Hip - methods Arthroplasty, Replacement, Knee - methods Aspirin Clinical trials Coagulation Comparative Effectiveness Research Factor Xa Inhibitors - therapeutic use Female Health risk assessment Hemorrhage Hemorrhage - chemically induced Hemorrhage - drug therapy Heparin Heparin, Low-Molecular-Weight - therapeutic use Hip Humans Knee Male Meta-analysis Middle Aged Network Meta-Analysis Odds Ratio Patient Safety Prophylaxis Risk Thromboembolism Thromboembolism - drug therapy Thrombosis total hip replacement total knee replacement venous thromboembolism Venous Thromboembolism - chemically induced Venous Thromboembolism - prevention & control Venous Thrombosis - drug therapy Vitamin K |
| title | Comparative effectiveness of venous thromboembolism prophylaxis options for the patient undergoing total hip and knee replacement: a network meta‐analysis |
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