Anticoagulants (chosen at investigators' discretion) compared to placebo for prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair | ||||||
Patient or population: people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair Setting: hospital and outpatient setting Intervention: anticoagulant (chosen at investigators' discretion) Comparison: placebo | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
Risk with placebo | Risk with anticoagulant (chosen at investigators' discretion) | |||||
Total VTE (symptomatic and asymptomatic) Treatment duration 28 ‐ 42 days |
Study population | OR 0.26 (0.14 to 0.50) | 557 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1 | — | |
158 per 1000 | 46 per 1000 (26 to 86) | |||||
Asymptomatic DVT Treatment duration 28 ‐ 42 days |
Study population | OR 0.26 (0.13 to 0.54) | 557 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1 | — | |
125 per 1000 | 36 per 1000 (18 to 72) | |||||
Asymptomatic proximal DVT Treatment duration 28 ‐ 42 days |
see comment | — | — | — | not reported in single included study in this comparison | |
Asymptomatic distal DVT Treatment duration 28 ‐ 42 days |
Study population | OR 0.26 (0.13 to 0.54) | 557 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1 | — | |
125 per 1000 | 36 per 1000 (18 to 72) | |||||
All‐cause mortality Treatment duration 28 ‐ 42 days |
see comment | — | 842 (1 RCT) | — | the single included study reported no deaths in either study arm | |
Adverse events Treatment duration 28 ‐ 42 days |
see comment | — | — | — | not reported in single included study in this comparison | |
Reoperation Treatment duration 28 ‐ 42 days | see comment | — | — | — | outcome reported as part of the definition of the outcome major bleeding but data not reported separately | |
Wound infection Treatment duration 28 ‐ 42 days |
see comment | — | — | — | not reported in single included study in this comparison | |
Wound healing Treatment duration 28 ‐ 42 days |
see comment | — | — | — | not reported in single included study in this comparison | |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Ccnfidence interval; DVT: deep vein thrombosis; OR: odds ratio; PE: pulmonary embolism; RCT: randomised controlled trial; VTE: venous thromboembolism | ||||||
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |