Yang Liu1, Hong Xu2, Feifei Liu3, Zenghui Lv4, Shunli Kan5, Guangzhi Ning6, Shiqing Feng7. 1. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: liuyang_orthopedics@foxmail.com. 2. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: xiaoranxuhong@163.com. 3. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: liufeif@163.com. 4. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: lvzh1989@126.com. 5. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: kanshunli@hotmail.com. 6. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: ninggz_tmu@foxmail.com. 7. Department of Orthopaedics, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, China. Electronic address: sqfeng@tmu.edu.cn.
Abstract
OBJECTIVE: Venous thromboembolism (VTE) is a frequent complication in patients with acute spinal cord injury (SCI) and may have serious consequences. This study aimed to assess the efficacy and safety of heparin and low-molecular-weight heparin (LMWH) venous thromboprophylaxis in patients with acute SCI. METHODS: PubMed, Web of Science, EMBASE and the Cochrane library were searched from January 1980 to August 2016. The primary outcome was the incidence of VTE. Secondary outcomes included the incidences of Deep-vein thrombosis (DVT), pulmonary embolism (PE) and major bleeding. RESULTS: A total of 11 studies including 1605 patients qualified for inclusion. Four studies evaluated the efficacy of heparin treatment compared with placebo or no treatment. There were significant differences between the two treatments, and the summary RR was 0.35 (95% confidence interval (CI) 0.15-0.87; P = 0.02). Seven studies compared low dose unfractionated heparin (LDUH) with LMWH. The incidence of VTE was not significantly different between the two treatments (RR 1.09, 95% CI 0.63-1.89; P = 0.76). There were no differences in the incidence of major bleeding with unfractionated heparin versus LMWH (summary RR 1.32, 95% CI 0.62-2.84; P = 0.47). CONCLUSIONS: In this meta-analysis, heparin exhibited protective effects compared with placebo or no treatment with respect to the occurrence of VTE; there were no differences between LMWH and unfractionated heparin with ret to thromboembolism prophylaxis efficacy. LMWH did not reduce the risk of bleeding compared with LDUH.
OBJECTIVE:Venous thromboembolism (VTE) is a frequent complication in patients with acute spinal cord injury (SCI) and may have serious consequences. This study aimed to assess the efficacy and safety of heparin and low-molecular-weight heparin (LMWH) venous thromboprophylaxis in patients with acute SCI. METHODS: PubMed, Web of Science, EMBASE and the Cochrane library were searched from January 1980 to August 2016. The primary outcome was the incidence of VTE. Secondary outcomes included the incidences of Deep-vein thrombosis (DVT), pulmonary embolism (PE) and major bleeding. RESULTS: A total of 11 studies including 1605 patients qualified for inclusion. Four studies evaluated the efficacy of heparin treatment compared with placebo or no treatment. There were significant differences between the two treatments, and the summary RR was 0.35 (95% confidence interval (CI) 0.15-0.87; P = 0.02). Seven studies compared low dose unfractionated heparin (LDUH) with LMWH. The incidence of VTE was not significantly different between the two treatments (RR 1.09, 95% CI 0.63-1.89; P = 0.76). There were no differences in the incidence of major bleeding with unfractionated heparin versus LMWH (summary RR 1.32, 95% CI 0.62-2.84; P = 0.47). CONCLUSIONS: In this meta-analysis, heparin exhibited protective effects compared with placebo or no treatment with respect to the occurrence of VTE; there were no differences between LMWH and unfractionated heparin with ret to thromboembolism prophylaxis efficacy. LMWH did not reduce the risk of bleeding compared with LDUH.
Authors: Ze Lin; Yun Sun; Hang Xue; Lang Chen; Chenchen Yan; Adriana C Panayi; Bobin Mi; Guohui Liu Journal: J Orthop Surg Res Date: 2021-04-14 Impact factor: 2.359