The risk of postoperative hemorrhage and efficacy of heparin for preventing deep vein thrombosis and pulmonary embolism in adult patients undergoing neurosurgery: a systematic review and meta-analysis
| Autor: | Peng Fu, Yun Sun, Ying-Chun Zhou, De-Qiang Lei, Xuan Wang, Wen-De Zhu, Hongyang Zhao |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Deep vein Neurosurgery Postoperative Hemorrhage Placebo General Biochemistry Genetics and Molecular Biology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans 030212 general & internal medicine Randomized Controlled Trials as Topic Venous Thrombosis business.industry Heparin Retrospective cohort study General Medicine Middle Aged medicine.disease Thrombosis Surgery Pulmonary embolism medicine.anatomical_structure Treatment Outcome Anesthesia business Pulmonary Embolism Publication Bias 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of investigative medicine : the official publication of the American Federation for Clinical Research. 65(8) |
| ISSN: | 1708-8267 |
| Popis: | The aim of this meta-analysis was to examine the risk of postoperative bleeding and efficacy of heparin for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in adult patients undergoing neurosurgery. MEDLINE, Cochrane, and EMBASE databases were searched until October 31, 2016, for randomized controlled trials (RCTs) and non-randomized comparative studies that assessed the rates of postoperative hemorrhage, DVT, PE, and mortality in adult patients undergoing neurosurgery. Nine eligible studies (five RCTs, four retrospective studies) including 874 patients treated with either unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) and 1033 patients in control group (placebo with or without compression device) were analyzed. The overall analysis revealed that there was an increase in the risk of postoperative hemorrhage in patients who received heparin (pooled OR 1.66, 95% CI 1.01 to 2.72, p=0.046) compared with no treatment group. The risk of postoperative hemorrhage was more significant if only RCTs were included in analysis. Heparin prophylaxis was associated with a decrease in the risk of DVT (pooled OR 0.48, 95% CI 0.36 to 0.65, p |
| Databáze: | OpenAIRE |
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