Association between aspirin use and deep venous thrombosis in mechanically ventilated ICU patients

Gupta, Ena; Siddiqi, Furqan Shoaib; Kunjal, Ryan; Faisal, Muhammad; Al‐Saffar, Farah; Bajwa, Abubakr; Jones, Lisa; Seeram, Vandana; Cury, James; Shujaat, Adil

doi:10.1007/s11239-017-1525-x

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…Aspirin has been shown to decrease the risk of VTE in surgical and high-risk medical patients but its effects in mechanically ventilated ICU patients are unknown. A study designed to investigate the effect of aspirin on thromboembolic events in mechanically ventilated patients showed a significant reduction in the odds of finding DVT with aspirin (OR 0.39, 95% CI 0.16–0.94; p = 0.036) [ 42 ]. So, aspirin may be helpful in preventing DVT in such patients.…”

Section: Reviewmentioning

confidence: 99%

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Ejaz

Ahmed

Tasleem

et al. 2018

Cureus

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Thromboembolism is a major complication in hospitalized patients. Intensive care unit (ICU) patients have a greater risk of thrombotic events due to additional risk factors such as immobilization, mechanical ventilation, and central catheters. The diagnosis and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in critically ill patients are challenging and these conditions are associated with high mortality. Medical thromboprophylaxis with low molecular weight heparin (LMWH) as well as unfractionated heparin (UFH) has been shown to reduce the incidence of thromboembolic events in such patients. For patients with high risk of bleeding, mechanical thromboprophylaxis can be used. Literature database was conducted on Medline for articles published up to 2018 using particular search terms such as thromboprophylaxis and venous thromboembolism in ICU patients. The following review summarizes the existing data regarding thromboprophylaxis in ICU patients with special consideration to the use of mechanical prophylaxis and pharmacologic prophylaxis using heparin products.

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Section: Reviewmentioning

confidence: 99%

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Ejaz

Ahmed

Tasleem

et al. 2018

Cureus

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“…There was one study (198 patients) involving a specialized cardiac ICU (36), three studies (3,317 patients) involving neurologic ICUs (37)(38)(39), and four studies (1,101 patients) involving trauma ICUs (40)(41)(42)(43). Most studies evaluated any symptomatic VTE (DVT or PE) as the primary outcome, though some studies evaluated only DVT (2,(44)(45)(46)(47), only PE (6,36,37,40,(48)(49)(50), or only CVC-associated DVT (39,51). Of the 20 studies evaluating lower e373 extremity DVTs, nine studies included both proximal and distal DVTs (38,43,47,(52)(53)(54)(55)(56).…”

Section: Search Resultsmentioning

confidence: 99%

Prognostic Factors Associated With Development of Venous Thromboembolism in Critically Ill Patients—A Systematic Review and Meta-Analysis

Tran

Fernando

Rochwerg

et al. 2021

Critical Care Medicine

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OBJECTIVE: To identify prognostic factors for the development of venous thromboembolism in the ICU. DATA SOURCES: We searched MEDLINE, EMBASE, and Cochrane CENTRAL from inception to March 1, 2021. STUDY SELECTION: We included English-language studies describing prognostic factors associated with the development of venous thromboembolism among critically ill patients. DATA EXTRACTION: Two authors performed data extraction and risk-of-bias assessment. We pooled adjusted odds ratios and adjusted hazard ratios for prognostic factors using random-effects model. We assessed risk of bias using the Quality in Prognosis Studies tool and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach. DATA SYNTHESIS: We included 39 observational cohort studies involving 729,477 patients. Patient factors with high or moderate certainty of association with increased odds of venous thromboembolism include older age (adjusted odds ratio, 1.15; 95% CI, 1.02–1.29 per 10 yr), obesity (adjusted odds ratio, 1.25; 95% CI, 1.18–1.32), active malignancy (adjusted odds ratio, 1.70; 95% CI, 1.18–2.44), history of venous thromboembolism (adjusted odds ratio, 4.77; 95% CI, 3.42–6.65), and history of recent surgery (adjusted odds ratio, 1.77; 95% CI, 1.26–2.47). ICU-specific factors with high or moderate certainty of association with increased risk of venous thromboembolism include sepsis (adjusted odds ratio, 1.41; 95% CI, 1.12–1.78), lack of pharmacologic venous thromboembolism prophylaxis (adjusted odds ratio, 1.80; 95% CI, 1.14–2.84), central venous catheter (adjusted odds ratio, 2.93; 95% CI, 1.98–4.34), invasive mechanical ventilation (adjusted odds ratio, 1.74; 95% CI, 1.36–2.24), and use of vasoactive medication (adjusted odds ratio, 1.86; 95% CI, 1.23–2.81). CONCLUSIONS: This meta-analysis provides quantitative summaries of the association between patient-specific and ICU-related prognostic factors and the risk of venous thromboembolism in the ICU. These findings provide the foundation for the development of a venous thromboembolism risk stratification tool for critically ill patients.

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“…At present, no clinical trials exist that relate the use of antiplatelet agents in critically ill patients in prophylactic anticoagulation. In a retrospective study of 193 mechanically ventilated patients, multivariate regression analysis showed that the use of aspirin during hospitalization could reduce the risk of DVT (OR = 0.39, 95% CI = 0.16-0.94) [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Risk Assessment Model for Venous Thromboembolism in Patients With Invasive Mechanical Ventilation

Lin¹,

Zhang²,

Lin³

et al. 2022

Cureus

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BackgroundPatients with invasive mechanical ventilation may be at high risk of acquiring venous thromboembolism (VTE). We aim to develop risk assessment models for predicting the improvement of VTE in invasively ventilated patients. MethodologyA total of 6,734 invasively ventilated patients enrolled from the Medical Information Mart for Intensive Care-III (MIMIC-III) database were used as input for model development and internal validation, while data from 168 patients from Nanfang Hospital were used for external validation. Logistic regression was performed based on predictive factors derived from least absolute shrinkage and selection operator (LASSO) regression analysis and logistic regression with backward selection to develop two Risk Assessment Models (RAM), namely, I and II, for the prediction of VTE, respectively. Model selection was performed by evaluation of the area under the receiver operating characteristic curve (AUC), the goodness of fit with calibration curves, and decision curve analyses (DCA). ResultsRAM-I included prior history of VTE, in-hospital immobilization, infection, glucose, the use of antiplatelet, and activated partial thromboplastin time (APTT) as variables, while RAM-II included prior history of VTE, in-hospital immobilization, infection, ischemic stroke, glucose, the use of antiplatelet and APTT as variables. Compared with RAM-I and ICU-Venous Thromboembolism Score, RAM-II exhibited better discrimination in the training dataset (AUC = 0.826), internal validation dataset (AUC = 0.771), and external validation dataset (AUC = 0.770). Additionally, DCA demonstrated that RAM-II was clinically beneficial. Inspection of the calibration curves revealed good agreement between the predictions and observations. ConclusionsA RAM for VTE in invasively ventilated patients was developed with reasonable performance.

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Association between aspirin use and deep venous thrombosis in mechanically ventilated ICU patients

Cited by 6 publications

References 26 publications

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Thromboprophylaxis in Intensive Care Unit Patients: A Literature Review

Prognostic Factors Associated With Development of Venous Thromboembolism in Critically Ill Patients—A Systematic Review and Meta-Analysis

Development and Validation of a Risk Assessment Model for Venous Thromboembolism in Patients With Invasive Mechanical Ventilation

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