Evidence map›Paper›PMID 37310606›Full record

Trial reportCanadian journal of anaesthesia = Journal canadien d'anesthesie2023

Sex differences in thromboprophylaxis of the critically ill: a secondary analysis of a randomized trial.

Karen E A Burns, Diane Heels-Ansdell, Lehana Thabane, Susan R Kahn, Francois Lauzier, Sangeeta Mehta, Marlies Ostermann, Pulkit Bhuptani, Mark A Crowther, Simon Finfer and 2 more

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Karen E A BurnsInterdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-9967-5424
Diane Heels-AnsdellDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Susan R KahnDepartment of Medicine, McGill University, Montreal, QC, Canada.
Francois LauzierResearch Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, QC, Canada.
Sangeeta MehtaInterdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Marlies OstermannDepartment of Critical Care and Nephrology, King's College London, Guy's and St Thomas' Hospital, London, UK.
Pulkit BhuptaniDepartment of Pharmacy, Unity Health Toronto-St. Michael's Hospital, Toronto, ON, Canada.
Mark A CrowtherSt. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada.
Simon FinferClinical Trials Unit, The George Institute, Sydney, NSW, Australia.
Deborah J CookDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
PROTECT Investigators, the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVenous thromboembolism (VTE) is a common complication of critical illness. Sex- or gender-based analyses are rarely conducted and their effect on outcomes is unknown. We assessed for an effect modification of thromboprophylaxis (dalteparin or unfractionated heparin [UFH]) by sex on thrombotic (deep venous thrombosis [DVT], pulmonary embolism [PE], VTE) and mortality outcomes in a secondary analysis of the Prophylaxis for Thromboembolism in Critical Care Trial (PROTECT).

methodsWe conducted unadjusted analyses using Cox proportional hazards analysis, stratified by centre and admission diagnostic category, including sex, treatment, and an interaction term. Additionally, we performed adjusted analyses and assessed the credibility of our findings.

resultsCritically ill female (n = 1,614) and male (n = 2,113) participants experienced similar rates of DVT, proximal DVT, PE, any VTE, ICU death, and hospital death. In unadjusted analyses, we did not find significant differences in treatment effect favouring males (vs females) treated with dalteparin (vs UFH) for proximal leg DVT, any DVT, or any PE, but found a statistically significant effect (moderate certainty) favouring dalteparin in males for any VTE (males: hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52 to 0.96 vs females: HR, 1.16; 95% CI, 0.81 to 1.68; P = 0.04). This effect remained after adjustment for baseline characteristics (males: HR, 0.70; 95% CI, 0.52 to 0.96 vs females: HR, 1.17; 95% CI, 0.81 to 1.68; P = 0.04) and weight (males: HR, 0.70; 95% CI, 0.52 to 0.96 vs females: HR, 1.20; 95% CI, 0.83 to 1.73; P = 0.03). We did not identify a significant effect modification by sex on mortality.

conclusionsWe found an effect modification by sex of thromboprophylaxis on VTE in critically ill patients that requires confirmation. Our findings highlight the need for sex- and gender-based analyses in acute care research.

Indexed as

Pulmonary EmbolismVenous ThromboembolismAnticoagulantsCritical IllnessDalteparinFemaleHeparinHumansMaleSex CharacteristicsAnticoagulantsDalteparinHeparindeep venous thrombosisprophylaxispulmonary embolismsex differencesvenous thromboembolism

Identifiers

PMID37310606

What Socratic holds

Textmetadata
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 Socratic graph.