Evidence map›Paper›PMID 22315261›Full record

GuidelineChest2012

Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Susan R Kahn, Wendy Lim, Andrew S Dunn, Mary Cushman, Francesco Dentali, Elie A Akl, Deborah J Cook, Alex A Balekian, Russell C Klein, Hoang Le and 2 more

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 602 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
602citing papers in PubMed, 15 pooled it
153.5field-weighted citation impact, top 1% 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.

NCT01853202 nacompletednot on this mapstarted 2013, after this paper: background citation

EXercise Training for the Prevention of Cancer Thrombosis (EXPECT) Pilot Trial

TypeinterventionalSponsorUniversity of VermontRan2013Enrolled40ConditionsCancer ThrombosisArmsSupervised aerobic exercise training
NCT02719418 completednot on this mapstarted 2016, after this paper: background citation

Study of the Bioaccumulation of Tinzaparin in Renally Impaired Patients When Given at Prophylactic Doses

TypeobservationalSponsorMaisonneuve-Rosemont HospitalRan2016 to 2018Enrolled28ConditionsRenal Insufficiency, Chronic, Deep Venous Thrombosis, Protection AgainstArmsTinzaparin
3 · Its place in the literature

Who cites it

602 citing papers in PubMed, 15 syntheses or guidelines pooled it, 2,664 citations in OpenAlex.

  1. Guideline
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  12. Travel-Associated Venous Thromboembolism.Wilderness & environmental medicine · 2022
    Pooled it
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  16. Trial
  17. Sex differences in thromboprophylaxis of the critically ill: a secondary analysis of a randomized trial.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023
    Trial
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542 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 3 countries.

Susan R KahnDepartment of Medicine, McGill University, Montreal, QC, Canada.
Wendy LimDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Andrew S DunnDepartment of Medicine, Mount Sinai School of Medicine, New York, NY.
Mary CushmanDepartment of Medicine, University of Vermont and Fletcher Allen Health Care, Burlington, VT.
Francesco DentaliDepartment of Clinical Medicine, University of Insubria, Varese, Italy.
Elie A AklDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, University at Buffalo, Buffalo, NY.
Deborah J CookDepartment of Medicine, McMaster University, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Alex A BalekianDivision of Pulmonary and Critical Care Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Russell C KleinHuntington Beach Internal Medicine Group, Newport Beach, CA; Department of Pulmonary and Critical Care Medicine, University of California Irvine School of Medicine, Orange, CA.
Hoang LeHoag Memorial Hospital Presbyterian, Newport Beach, CA; Pulmonary Division, Fountain Valley Regional Hospital, Fountain Valley, CA.
Sam SchulmanDivision of Hematology and Thromboembolism, McMaster University, Hamilton, ON, Canada.
M Hassan MuradDivision of Preventive Medicine and the Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN. Electronic address: Murad.Mohammad@mayo.edu.
McMaster University · CAHoag Memorial Hospital Presbyterian · USIcahn School of Medicine at Mount Sinai · USMayo Clinic in Arizona · USMcGill University · CAUniversity at Buffalo, State University of New York · USUniversity of California, Irvine · USUniversity of Insubria · ITUniversity of Southern California · USUniversity of Vermont · US

Funding

NCATS NIH HHS UL1 TR000130NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

backgroundThis guideline addressed VTE prevention in hospitalized medical patients, outpatients with cancer, the chronically immobilized, long-distance travelers, and those with asymptomatic thrombophilia.

methodsThis guideline follows methods described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

resultsFor acutely ill hospitalized medical patients at increased risk of thrombosis, we recommend anticoagulant thromboprophylaxis with low-molecular-weight heparin (LMWH), low-dose unfractionated heparin (LDUH) bid, LDUH tid, or fondaparinux (Grade 1B) and suggest against extending the duration of thromboprophylaxis beyond the period of patient immobilization or acute hospital stay (Grade 2B). For acutely ill hospitalized medical patients at low risk of thrombosis, we recommend against the use of pharmacologic prophylaxis or mechanical prophylaxis (Grade 1B). For acutely ill hospitalized medical patients at increased risk of thrombosis who are bleeding or are at high risk for major bleeding, we suggest mechanical thromboprophylaxis with graduated compression stockings (GCS) (Grade 2C) or intermittent pneumatic compression (IPC) (Grade 2C). For critically ill patients, we suggest using LMWH or LDUH thromboprophylaxis (Grade 2C). For critically ill patients who are bleeding or are at high risk for major bleeding, we suggest mechanical thromboprophylaxis with GCS and/or IPC at least until the bleeding risk decreases (Grade 2C). In outpatients with cancer who have no additional risk factors for VTE we suggest against routine prophylaxis with LMWH or LDUH (Grade 2B) and recommend against the prophylactic use of vitamin K antagonists (Grade 1B).

conclusionsDecisions regarding prophylaxis in nonsurgical patients should be made after consideration of risk factors for both thrombosis and bleeding, clinical context, and patients' values and preferences.

Indexed as

Evidence-Based MedicineSocieties, MedicalAmbulatory CareCombined Modality TherapyCritical CareFibrinolytic AgentsFondaparinuxHemorrhageHeparinHeparin, Low-Molecular-WeightHospitalizationHumansImmobilizationIntermittent Pneumatic Compression DevicesNeoplasmsPolysaccharidesFibrinolytic AgentsFondaparinuxHeparinHeparin, Low-Molecular-WeightPolysaccharides

Identifiers

PMID22315261
PMCPMC3278052
OpenAlexW2110992040

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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 Socratic graph.