Evidence mapPaperPMID 38432204Full record

SynthesisActa haematologica2024

Venous Thromboembolism Prophylaxis in Inflammatory Bowel Disease Inpatients: Systematic Review and Meta-Analysis.

Rotem McNeil, Danielle Fredman, Ofir Eldar, Anat Gafter-Gvili, Tomer Avni

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Acta haematologica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  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

5 authors.

Rotem McNeilInternal Medicine Department A, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Danielle FredmanInternal Medicine Department A, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Ofir EldarInternal Medicine Department A, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Anat Gafter-GviliInternal Medicine Department A, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Tomer AvniInternal Medicine Department A, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInflammatory bowel disease (IBD) patients are three times more likely to develop venous thromboembolism (VTE), and guidelines recommend prophylaxis during all hospitalizations. In this systematic review, we sought to assess for the benefits and risks of VTE prophylaxis in hospitalized IBD patients.

methodsWe performed a systematic review and meta-analysis. We searched MEDLINE and others up to 2/2022, for studies on IBD inpatients treated with prophylactic anticoagulation during hospitalization, compared to no prophylaxis. Primary efficacy and safety outcomes were any VTE and major bleeding, respectively. Results were pooled using random-effects models, calculating odds ratios (OR), and 95% confidence intervals (CI). The ROBINS-I tool was used to assess bias.

resultsWe extracted data from 18 observational studies and 2 randomized-trial subgroups. The studies were highly variable regarding the included populations, interventions, and outcome definitions. Meta-analysis of all studies showed a nonsignificant effect of prophylaxis on VTEs (OR: 0.97 [95% CI: 0.49-1.95]). An analysis of eight lower-risk-of-bias studies showed a significant reduction in VTEs (OR: 0.27 [95% CI: 0.13-0.55], number needed to treat (NNT) 34.8 [95% CI: 26.8-49.8]). A significant protective effect persisted in several subgroups. Major bleeding was reported in three studies and showed a significant increase with prophylaxis (OR: 2.02 [95% CI: 1.11-3.67], number needed to harm (NNH) 113.6 [95% CI: 40.7-very-large-number]).

conclusionIn studies with lower-risk-of-bias, a significant reduction in VTEs was shown in patients treated with VTE prophylaxis (NNT = 35), which should be carefully considered against an increased major-bleeding risk (NNH = 114). However, current data are limited and randomized trials dedicated to IBD inpatients would aid in understating whether universal prophylaxis should be recommended.

Indexed as

AnticoagulantsInflammatory Bowel DiseasesVenous ThromboembolismHemorrhageHospitalizationHumansInpatientsAnticoagulantsAnticoagulationInflammatory bowel diseaseVenous thromboembolismVenous thromboembolism prophylaxis

Identifiers

PMID38432204
PMCPMC11610454

What Socratic holds

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Registered trials

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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 Socratic graph.