Introduction
Review methods
Literature search and level of evidence assessment
Spontaneous intracranial hemorrhage expansion investigations
Post-chemoprophylaxis intracranial hemorrhage expansion proportions
Deep vein thrombosis proportions
Statistical analysis
Review results
Literature search and levels of evidence
Number
|
Reasons
| |
---|---|---|
Records identified through PubMed | 595 | |
Records after duplicates removed | 321 | |
Records screened | 321 | |
Full-text articles assessed for eligibility | 44 | |
Full-text articles excluded | 20 | No pertinent data |
Studies included in quantitative synthesis | 23 |
Study
|
Prospective
|
Comparison group
|
Level of evidence
|
---|---|---|---|
CP studies
| |||
Arnold et al. [28] | No | Yes | 3 |
Cothren et al. [21] | Yes | No | 5 |
Depew et al. [22] | No | Yes | 4 |
Dudley et al. [17] | No | Yes | 4 |
Kim et al. [18] | No | Yes | 4 |
Kleindienst et al. [23] | No | No | 5 |
Koehler et al. [19] | No | Yes | 4 |
Kurtoglu et al. [20] | Yes | Yes | 3 |
Levy et al. [11] | No | Yes | 3 |
Minshall et al. [12] | No | Yes | 3 |
Norwood et al. [24] | Yes | No | 5 |
Norwood et al. [13] | Yes | No | 5 |
Norwood et al. [14] | Yes | No | 5 |
Pahatouridis et al. [25] | Yes | No | 5 |
Phelan et al. [26] | Yes | Yes | 3 |
Saadeh et al. [15] | No | Yes | 4 |
Salottolo et al. [27] | No | Yes | 3 |
Scudday et al. [29] | No | Yes | 3 |
Non-CP studies
| |||
Bee et al. [4] | No | Yes | 4 |
Chang et al. [5] | No | Yes | 3 |
Park et al. [6] | No | Yes | 3 |
Phelan [16] | Yes | Yes | 3 |
Velmahos et al. [7] | No | Yes | 3 |
Spontaneous intracranial hemorrhage expansion proportions
Post-chemoprophylaxis intracranial hemorrhage expansion proportions
Study
|
ICH percentage
|
GCS/hAIS
|
Exclusions
|
CP day
|
---|---|---|---|---|
Dudley et al. [17] | NR | GCS 7 | None relevant | 3 |
Kim et al. [18] | 100 | GCS 9, hAIS >3 | Very few patients excluded | ≤3 |
Koehler et al. [19] | 100 | hAIS 3.7 | ICP device | 3 |
Koehler et al. [19] | 100 | hAIS 3.9 | ICP device | 5 |
Kurtoglu et al. [20] | 90 | GCS 3-8 | Craniotomy | 1 |
Levy et al. [11] | ~50 | hAIS 4 | Hospital LOS <3 days | 3 |
Minshall et al. [12] | 85 | hAIS 3.8 | Hospital LOS ≤48 hours | 47 hours |
Minshall et al. [12] | 85 | hAIS 4.1 | Hospital LOS ≤48 hours | 55 hours |
Saadeh et al. [15] | 100 | NR | Hospital LOS <3 days; no repeat CT | 2 |
Saadeh et al. [15] | 100 | NR | Hospital LOS <3 days; no repeat CT | ≥3 |
Study
|
ICH percentage
|
GCS/hAIS
|
Other exclusions
|
CP day
|
---|---|---|---|---|
Arnold et al. [28] | 100 | NR | DAI; cerebral edema; craniotomy | - |
Cothren et al. [21] | NR | GCS 3-7 | systemic anticoagulation; diagnosis of DVT; placement of vena cava filter | - |
Depew et al. [22] | 100 | MS ≥2 | Mass-effect | - |
Kleindienst et al. [23] | 36 | NR | None; 16% of candidates excluded | - |
Levy et al. [11] | ~50 | hAIS 4 | Hospital LOS <3 days | 3 |
Norwood et al. [24] | NR | GCS 3-8 | LOS <3 days; ISS <9; spinal cord injury; coagulopathy; LMWH not at appropriate time; no duplex scan at discharge; high risk for bleeding | - |
Norwood et al. [24] | NR | hAIS ≥2 | See above | - |
Norwood et al. [13] | 100 | GCS 10.0, hAIS 3.6 | LOS <2 days; coagulopathy; expected brain death | - |
Norwood et al. [14] | NR | GCS 10.4, hAIS 3.6 | Surgeon reluctance despite meeting criteria n = 24%; large ICH; persistent ICP >20; expected brain death; hospital LOS <3 days; solid organ injury; spinal cord hematoma; coagulopathy; pre-injury antithrombotic | - |
Pahatouridis et al. [25] | NR | GCS 9-12 | Extra-cranial injury; surgery; coagulopathy | - |
Phelan et al. [26] | 96 | GCS 13.5 | Large ICH; persistent ICP >20 torr | 1 |
Phelan et al. [26] | 93 | GCS 13.0 | Large ICH; persistent ICP >20 torr | 4 |
Salottolo et al. [27] | NR | GCS ≤8 (29%), hAIS 3.5 | Hospital LOS <3 days; death in 7 days; IVC filter; pre-injury antithrombotic | - |
Scudday et al. [29] | NR | GCS >9 (50%), hAIS 3.4 | Craniotomy; hospital LOS ≤3 days | - |
Study
|
Early ↑ ICH
|
Agent
|
CP day
|
Number
|
ICH ↑
|
Percentage
|
---|---|---|---|---|---|---|
Arnold et al. [28] | No | E | 8 | 99 | 2 | 2.0 |
Cothren et al. [21] | No | L | 3 | 174 | 0 | 0.0 |
Depew et al. [22] | No | E | ≤2 | 29 | 1 | 3.5 |
Depew et al. [22] | No | E | >3 | 53 | 2 | 3.8 |
Dudley et al. [17] | Yes | L | 3 | 287 | 1 | 0.3 |
Kim et al. [18] | Yes | H | ≤3 | 47 | 0 | 0.0 |
Kleindienst et al. [23] | No | L | 1 | 271 | 0 | 0.0 |
Koehler et al. [19] | Yes | L | 3 | 268 | 4 | 1.5 |
Koehler et al. [19] | Yes | L | 5 | 401 | 6 | 1.5 |
Kurtoglu et al. [20] | Yes | L | 1 | 60 | 1 | 1.7 |
Levy et al. [11] | Yes | L | 3 | 221 | 36 | 16.3 |
Levy et al. [11] | No | L | 3 | 163 | 15 | 9.2 |
Minshall et al. [12] | Yes | L | 2 | 158 | 8 | 5.1 |
Minshall et al. [12] | Yes | H | 2 | 171 | 20 | 11.7 |
Norwood et al. [24] | No | L | 1 | 36 | 0 | 0.0 |
Norwood et al. [24] | No | L | 1 | 19 | 0 | 0.0 |
Norwood et al. [13] | No | L | 1 | 150 | 6 | 4.0 |
Norwood et al. [14] | No | L | 2 | 525 | 18 | 3.4 |
Pahatouridis et al. [25] | No | L | 1 | 61 | 0 | 0.0 |
Phelan et al. [26] | No | L | 1 | 34 | 2 | 5.9 |
Phelan et al. [26] | No | L | 4 | 28 | 1 | 3.6 |
Saadeh et al. [15] | Yes | L | 2 | 46 | 0 | 0.0 |
Saadeh et al. [15] | Yes | L | ≥3 | 47 | 0 | 0.0 |
Salottolo et al. [27] | No | L | <3 | 108 | 7 | 6.5 |
Salottolo et al. [27] | No | L | ≥3 | 147 | 21 | 14.3 |
Scudday et al. [29] | No | E | 4 | 402 | 11 | 2.7 |
Total | 4,005 | 162 | 4.0 |
Deep vein thrombosis proportions
Study
|
Agent
|
IPC
|
IPCdur
|
CP day
|
RS
|
Number
|
DVT
|
Percentage
|
---|---|---|---|---|---|---|---|---|
Arnold et al. [28] | H | Yes | NS | 8 | No | 47 | 8 | 17.0 |
Arnold et al. [28] | L | Yes | NS | 8 | No | 52 | 6 | 11.5 |
Depew et al. [22] | E | Yes | Amb | <3 | Yes | 29 | 4 | 13.8 |
Depew et al. [22] | E | Yes | Amb | >3 | Yes | 53 | 6 | 11.3 |
Depew et al. [22] | N | Yes | Amb | None | ?? | 42 | 0 | 0.0 |
Dudley et al. [17] | L | Yes | Amb | 3 | No | 287 | 21 | 7.3 |
Kim et al. [18] | H | Yes | Amb | ≤3 | Yes | 47 | 2 | 4.3 |
Kim et al. [18] | H | Yes | Amb | >3 | Yes | 17 | 1 | 5.9 |
Kleindienst et al. [23] | L | CS | Amb | 1 | No | 280 | 0 | 0.0 |
Koehler et al. [19] | L | NS | NS | 3 | No | 268 | 4 | 1.5 |
Koehler et al. [19] | L | NS | NS | 5 | No | 401 | 14 | 3.5 |
Kurtoglu et al. [20] | L | Yes | NS | 1 | Yes | 60 | 3 | 5.0 |
Kurtoglu et al. [20] | N | Yes | NS | None | Yes | 60 | 4 | 6.7 |
Levy et al. [11] | L | Yes | Amb | 3 | Yes | 221 | 13 | 5.9 |
Levy et al. [11] | N | Yes | Amb | None | Yes | 119 | 2 | 1.7 |
Minshall et al. [12] | N | Yes | NS | None | No | 57 | 1 | 1.8 |
Minshall et al. [12] | L | Yes | NS | 2 | No | 158 | 1 | 0.6 |
Minshall et al. [12] | H | Yes | NS | 2 | No | 171 | 2 | 1.2 |
Norwood et al. [13] | L | Yes | CP | 1 | No | 150 | 2 | 1.3 |
Norwood et al. [14] | L | NS | NS | 2 | No | 525 | 6 | 1.1 |
Phelan et al. [26] | L | NS | NS | 1 | No | 34 | 0 | 0.0 |
Phelan et al. [26] | L | NS | NS | 4 | No | 28 | 1 | 3.6 |
Saadeh et al. [15] | L | Yes | NS | 2 | No | 46 | 0 | 0.0 |
Saadeh et al. [15] | L | Yes | NS | ≥3 | No | 47 | 0 | 0.0 |
Salottolo et al. [27] | N | Yes | NS | None | Yes | 225 | 4 | 1.8 |
Salottolo et al. [27] | L | Yes | NS | <3 | Yes | 108 | 5 | 4.6 |
Salottolo et al. [27] | L | Yes | NS | ≥3 | Yes | 147 | 3 | 2.0 |
Scudday et al. [29] | E | Yes | NS | 4 | No | 402 | 3 | 0.8 |
Scudday et al. [29] | N | Yes | NS | None | Yes | 410 | 11 | 2.7 |
Total | 4,491 | 127 | 2.8 |
CP day
|
Number
|
DVT
|
Percentage
|
95% CI
|
---|---|---|---|---|
Not given | 913 | 22 | 2.4% | 1.5-3.6% |
Days 1 to 3 | 2,384 | 63 | 2.6% | 2.1-3.4% |
Days 4 or 5 | 831 | 18 | 2.2% | 1.4-3.4% |
Day 8 | 99 | 14 | 14.1% | 8.6-22.4% |