Table 1. Comparison of total venous thromboembolism, deep vein thrombosis, pulmonary embolism, arterial thrombosis, bleeding events, and mortality according to pharmacologic thromboprophylaxis strategies.
| Outcomes | No prophylaxis | Standard-dose prophylaxis | Intermediate-dose prophylaxis | Therapeutic anticoagulants | Overall p -value a | |
|---|---|---|---|---|---|---|
| Total VTE b | No. of participants (No. of studies) | 276 (7) | 3,589 (29) | 458 (8) | 362 (9) | |
| Pooled incidence, % (95% CI) | 41.9 (28.1–57.2) | 19.8 (13.2– 28.6) | 11.9 (4.3–28.6) | 10.5 (4.2–23.8) | 0.003 | |
| I 2 , % | 76 | 95 | 90 | 82 | ||
| DVT | No. of participants (No. of studies) | 148 (3) | 1,816 (18) | 189 (3) | 125 (3) | |
| Pooled incidence, % (95% CI) | 20.0 (8.7–39.5) | 15.5 (11.9–14.4) | 11.9 (2.7–40.1) | 14.4 (1.6–63) | 0.92 | |
| I 2 , % | 73 | 94 | 88 | 92 | ||
| PE | No. of participants (No. of studies) | 57 (2) | 2,396 (14) | 387 (5) | 205 (5) | |
| Pooled incidence, % (95% CI) | 29.9 (1.2–93.5) | 6.5 (2.9–14.1) | 7.3 (1.8–25.4) | 11.2 (4.3–26.4) | 0.68 | |
| I 2 , % | 88 | 95 | 90 | 69 | ||
| Arterial thrombosis c | No. of participants (No. of studies) | 53 (1) | 1,057 (4) | 278 (3) | 76 (1) | |
| Pooled incidence, % (95% CI) | 11.3 (5.2–23.0) | 2.5 (1.4–4.3) | 2.1 (0.5–7.7) | 1.3 (0.2–8.8) | 0.009 | |
| I 2 , % | 0 | 45 | 45 | 0 | ||
| Bleeding d | No. of studies (No. of participants) | 936 (3) | 3,484 (5) | 194 (2) | 1,779 (3) | |
| Pooled incidence, % (95% CI) | 6.7 (2.2–19.0) | 1.7 (1.0–2.9) | 2.1 (0.8–5.4) | 6.3 (1.5–22.7) | 0.08 | |
| I 2 , % | 71 | 65 | 0 | 96 | ||
| Overall mortality | No. of participants (No. of studies) | 981 (2) | 2,529 (5) | 105 (1) | 1,530 (1) | |
| Pooled incidence, % (95% CI) | 23.1 (4.3–67.1) | 21.2 (17.3–25.7) | 21.0 (14.2–29.8) | 16.8 (15.0–18.8) | 0.19 | |
| I 2 , % | 96 | 57 | 0 | 0 | ||
Abbreviations: CI, confidence intervals; DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism.
a
p -Values were derived from the Q-test for heterogeneity among the four pharmacologic thromboprophylaxis strategy groups. A p -value of <0.05 was considered significant for between-group heterogeneity.
b
Total VTE included symptomatic or asymptomatic VTE (lower and upper extremity DVT, PE, and catheter-associated thrombosis).
c
Arterial thrombosis included acute coronary syndrome and cerebrovascular accidents.
d
Bleeding events were extracted as defined by individual studies.