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Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews.
Darzi, Andrea J; Repp, Allen B; Spencer, Frederick A; Morsi, Rami Z; Charide, Rana; Etxeandia-Ikobaltzeta, Itziar; Bauer, Kenneth A; Burnett, Allison E; Cushman, Mary; Dentali, Francesco; Kahn, Susan R; Rezende, Suely M; Zakai, Neil A; Agarwal, Arnav; Karam, Samer G; Lotfi, Tamara; Wiercioch, Wojtek; Waziry, Reem; Iorio, Alfonso; Akl, Elie A; Schünemann, Holger J.
Afiliação
  • Darzi AJ; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Repp AB; Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
  • Spencer FA; Department of Medicine, McMaster University, Hamilton, ON, Canada.
  • Morsi RZ; AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
  • Charide R; AUB GRADE Center, Clinical Research Institute, American University of Beirut, Beirut, Lebanon.
  • Etxeandia-Ikobaltzeta I; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Bauer KA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
  • Burnett AE; Inpatient Antithrombosis Service, University of New Mexico Health Sciences Center, Albuquerque, NM.
  • Cushman M; Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
  • Dentali F; Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
  • Kahn SR; Department of Medicine and Surgery, Insubria University, Varese, Italy.
  • Rezende SM; Department of Medicine, McGill University, Montreal, QC, Canada.
  • Zakai NA; Lady Davis Institute, Montreal, QC, Canada.
  • Agarwal A; Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
  • Karam SG; Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
  • Lotfi T; Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
  • Wiercioch W; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Waziry R; Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
  • Iorio A; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Akl EA; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
  • Schünemann HJ; Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote Cochrane Canada, McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada.
Blood Adv ; 4(19): 4929-4944, 2020 10 13.
Article em En | MEDLINE | ID: mdl-33049056
ABSTRACT
Multiple risk-assessment models (RAMs) for venous thromboembolism (VTE) in hospitalized medical patients have been developed. To inform the 2018 American Society of Hematology (ASH) guidelines on VTE, we conducted an overview of systematic reviews to identify and summarize evidence related to RAMs for VTE and bleeding in medical inpatients. We searched Epistemonikos, the Cochrane Database, Medline, and Embase from 2005 through June 2017 and then updated the search in January 2020 to identify systematic reviews that included RAMs for VTE and bleeding in medical inpatients. We conducted study selection, data abstraction and quality assessment (using the Risk of Bias in Systematic Reviews [ROBIS] tool) independently and in duplicate. We described the characteristics of the reviews and their included studies, and compared the identified RAMs using narrative synthesis. Of 15 348 citations, we included 2 systematic reviews, of which 1 had low risk of bias. The reviews included 19 unique studies reporting on 15 RAMs. Seven of the RAMs were derived using individual patient data in which risk factors were included based on their predictive ability in a regression analysis. The other 8 RAMs were empirically developed using consensus approaches, risk factors identified from a literature review, and clinical expertise. The RAMs that have been externally validated include the Caprini, Geneva, IMPROVE, Kucher, and Padua RAMs. The Padua, Geneva, and Kucher RAMs have been evaluated in impact studies that reported an increase in appropriate VTE prophylaxis rates. Our findings informed the ASH guidelines. They also aim to guide health care practitioners in their decision-making processes regarding appropriate individual prophylactic management.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tromboembolia Venosa Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Overview / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tromboembolia Venosa Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Overview / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article