HSC Section 3 - Trauma, Critical Care and Sleep Medicine

M OUBAYED ET AL .

(95% CI) Anticoagulation

Lee 25 2008 2b Discharged 9835 10 5 14 0.1 (0.1–0.2) 6 of 14 patients with VTE Lin 26 2012 2c Discharged 330,629 53 208,296 376 655 1031 0.3 (0.3–0.3) Not reported Mahboubi 27 2013 2c Discharged 6553 50 3178 18 12 30 0.5 (0.3–0.6) 40 0.6 (0.4–0.8) Not reported Marino 28 2014 2c 30 d 49,936 51 11,112 22 0 (0–0.1) 164 0.3 (0.3–0.4) Not reported Moreano 29 1998 2b Discharged 12,805 34 24 58 0.5 (0.3–0.6) 22 of patients with VTE were on prophylaxis Shuman 14 2012 2b 30 d 2016 11 16 27 1.3 (0.8–1.8) None Slattery 30 2001 2b Discharged 1687 50 822 4 4 0.2 (0–0.5) 15 0.9 (0.4–1.3) Not reported Spinazzi 31 2015 2c Discharged 15,317 50 7361 87 0.6 (0.4–0.7) 222 1.4 (1.3–1.6) Not reported Stack 32 2012 2c 30 d 21,057 59 5054 0 0 0 0 (0–0) 2 0 (0–0) Not reported Thai 17 2013 2b 30 d 134 65 103 1 1 2 1.5 (–0.6 to 3.5) 28 on SQH, 66 on ASA Yarlagadda 16 2014 2b Discharged 704 54 380 15 2.1 (1.1–3.2) 96 on ASA or Plavix Total 618,264 304,292 502 761 3184 0.4 (0.3–0.55) 342 0.9 (0.6–1.2)

TABLE 1. Included studies of incidence of venous thromboembolism in otolaryngology–head and neck surgery. Author Year CEBM LOE Obs. period Patients Age, y Sex (M) DVT PE VTE Ali 15 2015 2b Discharged 413 47 265 3 9 12 2.9 (1.3–4.5) All patients, SQH and elastic stockings Arriaga 18 1990 2b 30 d 414 62 1 2 3 0.7 (-0.1 to 1.5) 6 1.4 (0.3–2.6) Not reported Bahl 6 2014 2b 30 d 3498 26 23 49 1.4 (1–1.8) 75 2.1 (1.7–2.6) Sequential compressive device and SQH or LMWH or Fondaparinux Chen 19 2013 2c 30 d 48,028 52 12,343 42 0.1 (0.1–0.1) Not reported Clayburgh 8 2013 1b 30 d 100 63.5 58 7 1 8 8 (2.7–13.3) 8 8 (2.7–13.3) 14 patients received postoperative anticoagulation Cousins 20 1987 2b Discharged 374 70 329 3 1 4 1.1 (0–2.1) 13 3.5 (1.6–5.3) Not reported Garritano 21 2013 2b 30 d 5616 3 2 5 0.1 (0–0.2) 24 0.4 (0.3–0.6) All VTE patients were receiving prophylaxis Gavriel 13 2013 2b Discharged 1018 0 0 0 0 (0–0) 12 1.2 (0.5–1.8) 568 patients had chemoprophylaxis Hennessey 22 2012 2c Discharged 93,633 62 65,169 1860 2 (1.9–2.1) Not reported Innis 23 2009 2b Discharged 6124 66 6 1 7 0.1 (0–0.2) Most patients receive SQH Jain 24 2014 2c 30 d 6788 49.6 2720 3 4 7 0.1 (0–0.2) Not reported Karagama 12 2005 2b 6 wk 1585 1 1 0.1 (–0.1 to 0.2) Not reported %VTE (95% CI) Bleeding %Bleeding

Abbreviations: CEBM LOE, center for evidence based medicine levels of evidence; Obs. period, observation period; DVT, deep venous thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism; 95% CI, 95% confidence interval; SQH, subcutaneous heparin; LMWH, low-molecular weight heparin; ASA, aspirin.

HEAD & NECK—DOI 10.1002/HED JUNE 2017

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