Summary of findings 4. Combined mechanical and pharmacological prophylaxis compared to mechanical prophylaxis alone for preventing venous thromboembolism in people undergoing bariatric surgery.
| Combined mechanical and pharmacological prophylaxis compared to mechanical prophylaxis alone for preventing venous thromboembolism in people undergoing bariatric surgery | |||||
| Patient or population: people undergoing bariatric surgery Setting: hospital Intervention: combined mechanical and pharmacological prophylaxis Comparison: mechanical prophylaxis alone | |||||
| Outcomes | № of participants (studies) | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with mechanical prophylaxis alone | Risk with combined mechanical and pharmacological prophylaxis | ||||
| VTE Follow‐up: 4 weeks | 150 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | RR 0.05 (0.00 to 0.89) | Study population | |
| 120 per 1000 | 6 per 1000 (0 to 107) | ||||
| Major bleeding Follow‐up: 4 weeks | 150 (1 RCT) | ⊕⊕⊝⊝ Lowb | Not estimable | 1 study reported no events. | |
|
All‐cause mortality Follow‐up: 4 weeks |
150 (1 RCT) | ⊕⊕⊝⊝ Lowb | Not estimable | 1 study reported no events. | |
|
VTE‐related mortality Follow‐up: 4 weeks |
150 (1 RCT) | ⊕⊕⊝⊝ Lowb | Not estimable | 1 study reported no events. | |
| PE | Not reported | ||||
|
DVT Follow‐up: 4 weeks |
150 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | RR 0.05 (0.00 to 0.89) | Study population | |
| 120 per 1000 | 6 per 1000 (0 to 107) | ||||
| Adverse events | Not reported | ||||
| *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: confidence interval; DVT: deep vein thrombosis; PE: pulmonary embolism; RCT: randomised controlled trial; RR: risk ratio; VTE: venous thromboembolism. | |||||
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GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: 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 certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | |||||
aNumber needed to treat for an additional beneficial outcome (NNTB) = 9. bDowngraded two levels due to imprecision: few participants and few or no events.