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September 26, 2019HaematologicaOpen Access

Antithrombotic prophylaxis for surgery-associated venous thromboembolism risk in patients with inherited platelet disorders. The SPATA-DVT Study

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Key result

Thromboprophylaxis was used in 23.3% of surgical procedures in patients with inherited platelet disorders and was associated with zero venous thromboembolic events, whereas two events occurred in patients without prophylaxis.

Why the study?

The incidence of VTE and the current use and safety of thromboprophylaxis, particularly low-molecular-weight-heparin, in patients with inherited platelet disorders undergoing surgery are unknown.

Does thromboprophylaxis prevent venous thromboembolism in patients with inherited platelet disorders undergoing surgery?

Population

155 patients with well-defined forms of IPD undergoing 210 surgical procedures

Comparison

Thromboprophylaxis vs no thromboprophylaxis

Design

Multicenter observational study

Authors

FPFrancesco PaciulloLBLoredana BuryPNPatrizia Noris

Discussion

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Overview

Thromboprophylaxis may be considered in surgical patients with inherited platelet disorders; hypothesis-generating and requires prospective trials before practice change.

Study Design

Type

Observational (n=155)

Multicenter

Yes

Structured PICO

Does thromboprophylaxis prevent venous thromboembolism in patients with inherited platelet disorders undergoing surgery?

P
Population
155 patients aged 16 and older with inherited platelet disorders undergoing 210 surgical procedures at VTE-risk, evaluated for thromboprophylaxis use and 1-month thrombotic outcomes.
E
Exposure
Thromboprophylaxis (mechanical compression stockings/intermittent pneumatic compression or pharmacologic low-molecular-weight-heparin)
C
Comparator
No thromboprophylaxis
O
Outcome
Any symptomatic thrombosis (deep venous, including distal, and superficial) and/or pulmonary embolism occurring within one month after surgeryhard clinical

Main Result

Absolute Event Rate: 0% vs 1.2%

In patients with inherited platelet disorders, VTE incidence is low but predicted by the Caprini score, and thromboprophylaxis (mechanical or LMWH) appears safe and effective without increasing bleeding risk.

Limitations

  • Retrospective study design
  • Only symptomatic VTE was recorded, potentially underestimating total VTE incidence
  • Relatively small sample size and heterogeneous population
  • Lack of systematic instrumental diagnostics search for VTE during post-surgical follow-up

Cite This Study

Paciullo et al. (2019) conducted an observational in Inherited platelet disorders (n=155). Thromboprophylaxis (mechanical or pharmacologic) vs. No thromboprophylaxis was evaluated on Symptomatic venous thromboembolism (VTE) within one month after surgery. Thromboprophylaxis was used in 23.3% of surgical procedures in patients with inherited platelet disorders and was associated with zero venous thromboembolic events, whereas two events occurred in patients without prophylaxis.

synapsesocial.com/papers/6a6f2429febe604dd708281fhttps://doi.org/10.3324/haematol.2019.227876
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Incidence of Venous Thromboembolism and Benefits and Risks of Thromboprophylaxis After Cardiac Surgery: A Systematic Review and Meta‐Analysis2015 · 102 citations
  2. 2Graduated compression stockings in the prevention of venous thromboembolism1999 · 299 citations