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1. A comparison of computational algorithms for the Bayesian analysis of clinical trials.

Author

Chen, Ziming, Berger, Jeffrey, Castellucci, Lana, Farkouh, Michael, Goligher, Ewan, Hade, Erinn, Hunt, Beverley, Kornblith, Lucy, Lawler, Patrick, Leifer, Eric, Lorenzi, Elizabeth, Neal, Matthew, Zarychanski, Ryan, and Heath, Anna

Subjects
Bayesian clinical trial analysis, Integrated Nested Laplace Approximations, JAGS, Markov chain Monte Carlo, logistic regression, proportional odds model, stan, survival analysis, Bayes Theorem, Humans, Algorithms, Markov Chains, Monte Carlo Method, Male, Anticoagulants, COVID-19, Female, Heparin, SARS-CoV-2, Research Design
Abstract

BACKGROUND: Clinical trials are increasingly using Bayesian methods for their design and analysis. Inference in Bayesian trials typically uses simulation-based approaches such as Markov Chain Monte Carlo methods. Markov Chain Monte Carlo has high computational cost and can be complex to implement. The Integrated Nested Laplace Approximations algorithm provides approximate Bayesian inference without the need for computationally complex simulations, making it more efficient than Markov Chain Monte Carlo. The practical properties of Integrated Nested Laplace Approximations compared to Markov Chain Monte Carlo have not been considered for clinical trials. Using data from a published clinical trial, we aim to investigate whether Integrated Nested Laplace Approximations is a feasible and accurate alternative to Markov Chain Monte Carlo and provide practical guidance for trialists interested in Bayesian trial design. METHODS: Data from an international Bayesian multi-platform adaptive trial that compared therapeutic-dose anticoagulation with heparin to usual care in non-critically ill patients hospitalized for COVID-19 were used to fit Bayesian hierarchical generalized mixed models. Integrated Nested Laplace Approximations was compared to two Markov Chain Monte Carlo algorithms, implemented in the software JAGS and stan, using packages available in the statistical software R. Seven outcomes were analysed: organ-support free days (an ordinal outcome), five binary outcomes related to survival and length of hospital stay, and a time-to-event outcome. The posterior distributions for the treatment and sex effects and the variances for the hierarchical effects of age, site and time period were obtained. We summarized these posteriors by calculating the mean, standard deviations and the 95% equitailed credible intervals and presenting the results graphically. The computation time for each algorithm was recorded. RESULTS: The average overlap of the 95% credible interval for the treatment and sex effects estimated using Integrated Nested Laplace Approximations was 96% and 97.6% compared with stan, respectively. The graphical posterior densities for these effects overlapped for all three algorithms. The posterior mean for the variance of the hierarchical effects of age, site and time estimated using Integrated Nested Laplace Approximations are within the 95% credible interval estimated using Markov Chain Monte Carlo but the average overlap of the credible interval is lower, 77%, 85.6% and 91.3%, respectively, for Integrated Nested Laplace Approximations compared to stan. Integrated Nested Laplace Approximations and stan were easily implemented in clear, well-established packages in R, while JAGS required the direct specification of the model. Integrated Nested Laplace Approximations was between 85 and 269 times faster than stan and 26 and 1852 times faster than JAGS. CONCLUSION: Integrated Nested Laplace Approximations could reduce the computational complexity of Bayesian analysis in clinical trials as it is easy to implement in R, substantially faster than Markov Chain Monte Carlo methods implemented in JAGS and stan, and provides near identical approximations to the posterior distributions for the treatment effect. Integrated Nested Laplace Approximations was less accurate when estimating the posterior distribution for the variance of hierarchical effects, particularly for the proportional odds model, and future work should determine if the Integrated Nested Laplace Approximations algorithm can be adjusted to improve this estimation.

Published
2024

2. Effects of inflammation on thrombosis and outcomes in COVID-19: secondary analysis of the ATTACC/ACTIV-4a trial.

Author

Walborn, Amanda, Heath, Anna, Neal, Matthew, Zarychanski, Ryan, Kornblith, Lucy, Hunt, Beverley, Castellucci, Lana, Hochman, Judith, Lawler, Patrick, and Paul, Jonathan

Subjects
COVID-19, CRP, anticoagulation, heparin, thrombosis
Abstract

BACKGROUND: Patients hospitalized for COVID-19 are at high risk of thrombotic complications and organ failure, and often exhibit severe inflammation, which may contribute to hypercoagulability. OBJECTIVES: To determine whether patients hospitalized for COVID-19 experience differing frequencies of thrombotic and organ failure complications and derive variable benefits from therapeutic-dose heparin dependent on the extent of systemic inflammation and whether observed benefit from therapeutic-dose anticoagulation varies depending on the degree of systemic inflammation. METHODS: We analyzed data from 1346 patients hospitalized for COVID-19 enrolled in the ATTACC and ACTIV-4a platforms who were randomized to therapeutic-dose heparin or usual care for whom levels of C-reactive protein (CRP) were reported at baseline. RESULTS: Increased CRP was associated with worse patient outcomes, including a >98% posterior probability of increased organ support requirement, hospital length of stay, risk of 28-day mortality, and incidence of major thrombotic events or death (patients with CRP 40-100 mg/L or ≥100 mg/L compared to patients with CRP

Published
2023

11. Heparin Dose Intensity and Organ Support-Free Days in Patients Hospitalized for COVID-19

Author

Godoy, Lucas C., Neal, Matthew D., Goligher, Ewan C., Cushman, Mary, Houston, Brett L., Bradbury, Charlotte A., McQuilten, Zoe K., Tritschler, Tobias, Kahn, Susan R., Berry, Lindsay R., Lorenzi, Elizabeth, Jensen, Tom, Higgins, Alisa M., Kornblith, Lucy Z., Berger, Jeffrey S., Gong, Michelle N., Paul, Jonathan D., Castellucci, Lana A., Le Gal, Grégoire, Lother, Sylvain A., Rosenson, Robert S., Derde, Lennie P.G., Kumar, Anand, McVerry, Bryan J., Nicolau, Jose C., Leifer, Eric, Escobedo, Jorge, Huang, David T., Reynolds, Harmony R., Carrier, Marc, Kim, Keri S., Hunt, Beverley J., Slutsky, Arthur S., Turgeon, Alexis F., Webb, Steven A., McArthur, Colin J., Farkouh, Michael E., Hochman, Judith S., Zarychanski, Ryan, and Lawler, Patrick R.

Published
2024
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12. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition

Author

Rossaint, Rolf, Afshari, Arash, Bouillon, Bertil, Cerny, Vladimir, Cimpoesu, Diana, Curry, Nicola, Duranteau, Jacques, Filipescu, Daniela, Grottke, Oliver, Grønlykke, Lars, Harrois, Anatole, Hunt, Beverley J., Kaserer, Alexander, Komadina, Radko, Madsen, Mikkel Herold, Maegele, Marc, Mora, Lidia, Riddez, Louis, Romero, Carolina S., Samama, Charles-Marc, Vincent, Jean-Louis, Wiberg, Sebastian, and Spahn, Donat R.

Published
2023
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14. Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19

Author

Goligher, Ewan C, Bradbury, Charlotte A, McVerry, Bryan J, Lawler, Patrick R, Berger, Jeffrey S, Gong, Michelle N, Carrier, Marc, Reynolds, Harmony R, Kumar, Anand, Turgeon, Alexis F, Kornblith, Lucy Z, Kahn, Susan R, Marshall, John C, Kim, Keri S, Houston, Brett L, Derde, Lennie PG, Cushman, Mary, Tritschler, Tobias, Angus, Derek C, Godoy, Lucas C, McQuilten, Zoe, Kirwan, Bridget-Anne, Farkouh, Michael E, Brooks, Maria M, Lewis, Roger J, Berry, Lindsay R, Lorenzi, Elizabeth, Gordon, Anthony C, Ahuja, Tania, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen M, Aryal, Diptesh, Baumann Kreuziger, Lisa, Beane, Abi, Bhimani, Zahra, Bihari, Shailesh, Billett, Henny H, Bond, Lindsay, Bonten, Marc, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Castellucci, Lana A, Chekuri, Sweta, Chen, Jen-Ting, Cheng, Allen C, Chkhikvadze, Tamta, Coiffard, Benjamin, Contreras, Aira, Costantini, Todd W, de Brouwer, Sophie, Detry, Michelle A, Duggal, Abhijit, Džavík, Vladimír, Effron, Mark B, Eng, Heather F, Escobedo, Jorge, Estcourt, Lise J, Everett, Brendan M, Fergusson, Dean A, Fitzgerald, Mark, Fowler, Robert A, Froess, Joshua D, Fu, Zhuxuan, Galanaud, Jean P, Galen, Benjamin T, Gandotra, Sheetal, Girard, Timothy D, Goodman, Andrew L, Goossens, Herman, Green, Cameron, Greenstein, Yonatan Y, Gross, Peter L, Haniffa, Rashan, Hegde, Sheila M, Hendrickson, Carolyn M, Higgins, Alisa M, Hindenburg, Alexander A, Hope, Aluko A, Horowitz, James M, Horvat, Christopher M, Huang, David T, Hudock, Kristin, Hunt, Beverley J, Husain, Mansoor, Hyzy, Robert C, Jacobson, Jeffrey R, Jayakumar, Devachandran, Keller, Norma M, Khan, Akram, Kim, Yuri, Kindzelski, Andrei, King, Andrew J, Knudson, M Margaret, Kornblith, Aaron E, Kutcher, Matthew E, Laffan, Michael A, Lamontagne, Francois, and Le Gal, Grégoire

Subjects
Clinical Trials and Supportive Activities, Clinical Research, Comparative Effectiveness Research, Cardiovascular, Good Health and Well Being, Aged, Anticoagulants, COVID-19, Critical Illness, Female, Hemorrhage, Heparin, Hospital Mortality, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Respiration, Artificial, Thrombosis, Treatment Failure, COVID-19 Drug Treatment, REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundThrombosis and inflammation may contribute to morbidity and mortality among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation would improve outcomes in critically ill patients with Covid-19.MethodsIn an open-label, adaptive, multiplatform, randomized clinical trial, critically ill patients with severe Covid-19 were randomly assigned to a pragmatically defined regimen of either therapeutic-dose anticoagulation with heparin or pharmacologic thromboprophylaxis in accordance with local usual care. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge.ResultsThe trial was stopped when the prespecified criterion for futility was met for therapeutic-dose anticoagulation. Data on the primary outcome were available for 1098 patients (534 assigned to therapeutic-dose anticoagulation and 564 assigned to usual-care thromboprophylaxis). The median value for organ support-free days was 1 (interquartile range, -1 to 16) among the patients assigned to therapeutic-dose anticoagulation and was 4 (interquartile range, -1 to 16) among the patients assigned to usual-care thromboprophylaxis (adjusted proportional odds ratio, 0.83; 95% credible interval, 0.67 to 1.03; posterior probability of futility [defined as an odds ratio

Published
2021

15. Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19

Author

Lawler, Patrick R, Goligher, Ewan C, Berger, Jeffrey S, Neal, Matthew D, McVerry, Bryan J, Nicolau, Jose C, Gong, Michelle N, Carrier, Marc, Rosenson, Robert S, Reynolds, Harmony R, Turgeon, Alexis F, Escobedo, Jorge, Huang, David T, Bradbury, Charlotte A, Houston, Brett L, Kornblith, Lucy Z, Kumar, Anand, Kahn, Susan R, Cushman, Mary, McQuilten, Zoe, Slutsky, Arthur S, Kim, Keri S, Gordon, Anthony C, Kirwan, Bridget-Anne, Brooks, Maria M, Higgins, Alisa M, Lewis, Roger J, Lorenzi, Elizabeth, Berry, Scott M, Berry, Lindsay R, Aday, Aaron W, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen M, Aryal, Diptesh, Baumann Kreuziger, Lisa, Beane, Abi, Bhimani, Zahra, Bihari, Shailesh, Billett, Henny H, Bond, Lindsay, Bonten, Marc, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Castellucci, Lana A, Chekuri, Sweta, Chen, Jen-Ting, Cheng, Allen C, Chkhikvadze, Tamta, Coiffard, Benjamin, Costantini, Todd W, de Brouwer, Sophie, Derde, Lennie PG, Detry, Michelle A, Duggal, Abhijit, Džavík, Vladimír, Effron, Mark B, Estcourt, Lise J, Everett, Brendan M, Fergusson, Dean A, Fitzgerald, Mark, Fowler, Robert A, Galanaud, Jean P, Galen, Benjamin T, Gandotra, Sheetal, García-Madrona, Sebastian, Girard, Timothy D, Godoy, Lucas C, Goodman, Andrew L, Goossens, Herman, Green, Cameron, Greenstein, Yonatan Y, Gross, Peter L, Hamburg, Naomi M, Haniffa, Rashan, Hanna, George, Hanna, Nicholas, Hegde, Sheila M, Hendrickson, Carolyn M, Hite, R Duncan, Hindenburg, Alexander A, Hope, Aluko A, Horowitz, James M, Horvat, Christopher M, Hudock, Kristin, Hunt, Beverley J, Husain, Mansoor, Hyzy, Robert C, Iyer, Vivek N, Jacobson, Jeffrey R, Jayakumar, Devachandran, Keller, Norma M, Khan, Akram, Kim, Yuri, Kindzelski, Andrei L, King, Andrew J, Knudson, M Margaret, Kornblith, Aaron E, and Krishnan, Vidya

Subjects
Cardiovascular, Clinical Trials and Supportive Activities, Clinical Research, Hematology, Transplantation, Good Health and Well Being, Adult, Aged, Anticoagulants, COVID-19, Female, Hemorrhage, Heparin, Heparin, Low-Molecular-Weight, Hospital Mortality, Humans, Male, Middle Aged, Survival Analysis, Thrombosis, COVID-19 Drug Treatment, ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators, Medical and Health Sciences, General & Internal Medicine
Abstract

BackgroundThrombosis and inflammation may contribute to the risk of death and complications among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation may improve outcomes in noncritically ill patients who are hospitalized with Covid-19.MethodsIn this open-label, adaptive, multiplatform, controlled trial, we randomly assigned patients who were hospitalized with Covid-19 and who were not critically ill (which was defined as an absence of critical care-level organ support at enrollment) to receive pragmatically defined regimens of either therapeutic-dose anticoagulation with heparin or usual-care pharmacologic thromboprophylaxis. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge. This outcome was evaluated with the use of a Bayesian statistical model for all patients and according to the baseline d-dimer level.ResultsThe trial was stopped when prespecified criteria for the superiority of therapeutic-dose anticoagulation were met. Among 2219 patients in the final analysis, the probability that therapeutic-dose anticoagulation increased organ support-free days as compared with usual-care thromboprophylaxis was 98.6% (adjusted odds ratio, 1.27; 95% credible interval, 1.03 to 1.58). The adjusted absolute between-group difference in survival until hospital discharge without organ support favoring therapeutic-dose anticoagulation was 4.0 percentage points (95% credible interval, 0.5 to 7.2). The final probability of the superiority of therapeutic-dose anticoagulation over usual-care thromboprophylaxis was 97.3% in the high d-dimer cohort, 92.9% in the low d-dimer cohort, and 97.3% in the unknown d-dimer cohort. Major bleeding occurred in 1.9% of the patients receiving therapeutic-dose anticoagulation and in 0.9% of those receiving thromboprophylaxis.ConclusionsIn noncritically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge with reduced use of cardiovascular or respiratory organ support as compared with usual-care thromboprophylaxis. (ATTACC, ACTIV-4a, and REMAP-CAP ClinicalTrials.gov numbers, NCT04372589, NCT04505774, NCT04359277, and NCT02735707.).

Published
2021

16. Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19.

Author

REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators, Goligher, Ewan C, Bradbury, Charlotte A, McVerry, Bryan J, Lawler, Patrick R, Berger, Jeffrey S, Gong, Michelle N, Carrier, Marc, Reynolds, Harmony R, Kumar, Anand, Turgeon, Alexis F, Kornblith, Lucy Z, Kahn, Susan R, Marshall, John C, Kim, Keri S, Houston, Brett L, Derde, Lennie PG, Cushman, Mary, Tritschler, Tobias, Angus, Derek C, Godoy, Lucas C, McQuilten, Zoe, Kirwan, Bridget-Anne, Farkouh, Michael E, Brooks, Maria M, Lewis, Roger J, Berry, Lindsay R, Lorenzi, Elizabeth, Gordon, Anthony C, Ahuja, Tania, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen M, Aryal, Diptesh, Baumann Kreuziger, Lisa, Beane, Abi, Bhimani, Zahra, Bihari, Shailesh, Billett, Henny H, Bond, Lindsay, Bonten, Marc, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Castellucci, Lana A, Chekuri, Sweta, Chen, Jen-Ting, Cheng, Allen C, Chkhikvadze, Tamta, Coiffard, Benjamin, Contreras, Aira, Costantini, Todd W, de Brouwer, Sophie, Detry, Michelle A, Duggal, Abhijit, Džavík, Vladimír, Effron, Mark B, Eng, Heather F, Escobedo, Jorge, Estcourt, Lise J, Everett, Brendan M, Fergusson, Dean A, Fitzgerald, Mark, Fowler, Robert A, Froess, Joshua D, Fu, Zhuxuan, Galanaud, Jean P, Galen, Benjamin T, Gandotra, Sheetal, Girard, Timothy D, Goodman, Andrew L, Goossens, Herman, Green, Cameron, Greenstein, Yonatan Y, Gross, Peter L, Haniffa, Rashan, Hegde, Sheila M, Hendrickson, Carolyn M, Higgins, Alisa M, Hindenburg, Alexander A, Hope, Aluko A, Horowitz, James M, Horvat, Christopher M, Huang, David T, Hudock, Kristin, Hunt, Beverley J, Husain, Mansoor, Hyzy, Robert C, Jacobson, Jeffrey R, Jayakumar, Devachandran, Keller, Norma M, Khan, Akram, Kim, Yuri, Kindzelski, Andrei, King, Andrew J, Knudson, M Margaret, Kornblith, Aaron E, and Kutcher, Matthew E

Subjects
REMAP-CAP Investigators, ACTIV-4a Investigators, ATTACC Investigators, Humans, Thrombosis, Critical Illness, Hemorrhage, Heparin, Anticoagulants, Treatment Failure, Respiration, Artificial, Hospital Mortality, Logistic Models, Odds Ratio, Aged, Middle Aged, Female, Male, COVID-19, Clinical Research, Cardiovascular, Clinical Trials and Supportive Activities, Comparative Effectiveness Research, General & Internal Medicine, Medical and Health Sciences
Abstract

BackgroundThrombosis and inflammation may contribute to morbidity and mortality among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation would improve outcomes in critically ill patients with Covid-19.MethodsIn an open-label, adaptive, multiplatform, randomized clinical trial, critically ill patients with severe Covid-19 were randomly assigned to a pragmatically defined regimen of either therapeutic-dose anticoagulation with heparin or pharmacologic thromboprophylaxis in accordance with local usual care. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge.ResultsThe trial was stopped when the prespecified criterion for futility was met for therapeutic-dose anticoagulation. Data on the primary outcome were available for 1098 patients (534 assigned to therapeutic-dose anticoagulation and 564 assigned to usual-care thromboprophylaxis). The median value for organ support-free days was 1 (interquartile range, -1 to 16) among the patients assigned to therapeutic-dose anticoagulation and was 4 (interquartile range, -1 to 16) among the patients assigned to usual-care thromboprophylaxis (adjusted proportional odds ratio, 0.83; 95% credible interval, 0.67 to 1.03; posterior probability of futility [defined as an odds ratio

Published
2021

17. Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19.

Author

ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators, Lawler, Patrick R, Goligher, Ewan C, Berger, Jeffrey S, Neal, Matthew D, McVerry, Bryan J, Nicolau, Jose C, Gong, Michelle N, Carrier, Marc, Rosenson, Robert S, Reynolds, Harmony R, Turgeon, Alexis F, Escobedo, Jorge, Huang, David T, Bradbury, Charlotte A, Houston, Brett L, Kornblith, Lucy Z, Kumar, Anand, Kahn, Susan R, Cushman, Mary, McQuilten, Zoe, Slutsky, Arthur S, Kim, Keri S, Gordon, Anthony C, Kirwan, Bridget-Anne, Brooks, Maria M, Higgins, Alisa M, Lewis, Roger J, Lorenzi, Elizabeth, Berry, Scott M, Berry, Lindsay R, Aday, Aaron W, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen M, Aryal, Diptesh, Baumann Kreuziger, Lisa, Beane, Abi, Bhimani, Zahra, Bihari, Shailesh, Billett, Henny H, Bond, Lindsay, Bonten, Marc, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Castellucci, Lana A, Chekuri, Sweta, Chen, Jen-Ting, Cheng, Allen C, Chkhikvadze, Tamta, Coiffard, Benjamin, Costantini, Todd W, de Brouwer, Sophie, Derde, Lennie PG, Detry, Michelle A, Duggal, Abhijit, Džavík, Vladimír, Effron, Mark B, Estcourt, Lise J, Everett, Brendan M, Fergusson, Dean A, Fitzgerald, Mark, Fowler, Robert A, Galanaud, Jean P, Galen, Benjamin T, Gandotra, Sheetal, García-Madrona, Sebastian, Girard, Timothy D, Godoy, Lucas C, Goodman, Andrew L, Goossens, Herman, Green, Cameron, Greenstein, Yonatan Y, Gross, Peter L, Hamburg, Naomi M, Haniffa, Rashan, Hanna, George, Hanna, Nicholas, Hegde, Sheila M, Hendrickson, Carolyn M, Hite, R Duncan, Hindenburg, Alexander A, Hope, Aluko A, Horowitz, James M, Horvat, Christopher M, Hudock, Kristin, Hunt, Beverley J, Husain, Mansoor, Hyzy, Robert C, Iyer, Vivek N, Jacobson, Jeffrey R, Jayakumar, Devachandran, Keller, Norma M, Khan, Akram, Kim, Yuri, Kindzelski, Andrei L, and King, Andrew J

Subjects
ATTACC Investigators, ACTIV-4a Investigators, REMAP-CAP Investigators, Humans, Thrombosis, Hemorrhage, Heparin, Heparin, Low-Molecular-Weight, Anticoagulants, Hospital Mortality, Survival Analysis, Adult, Aged, Middle Aged, Female, Male, COVID-19, Hematology, Clinical Trials and Supportive Activities, Transplantation, Clinical Research, Cardiovascular, General & Internal Medicine, Medical and Health Sciences
Abstract

BackgroundThrombosis and inflammation may contribute to the risk of death and complications among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation may improve outcomes in noncritically ill patients who are hospitalized with Covid-19.MethodsIn this open-label, adaptive, multiplatform, controlled trial, we randomly assigned patients who were hospitalized with Covid-19 and who were not critically ill (which was defined as an absence of critical care-level organ support at enrollment) to receive pragmatically defined regimens of either therapeutic-dose anticoagulation with heparin or usual-care pharmacologic thromboprophylaxis. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge. This outcome was evaluated with the use of a Bayesian statistical model for all patients and according to the baseline d-dimer level.ResultsThe trial was stopped when prespecified criteria for the superiority of therapeutic-dose anticoagulation were met. Among 2219 patients in the final analysis, the probability that therapeutic-dose anticoagulation increased organ support-free days as compared with usual-care thromboprophylaxis was 98.6% (adjusted odds ratio, 1.27; 95% credible interval, 1.03 to 1.58). The adjusted absolute between-group difference in survival until hospital discharge without organ support favoring therapeutic-dose anticoagulation was 4.0 percentage points (95% credible interval, 0.5 to 7.2). The final probability of the superiority of therapeutic-dose anticoagulation over usual-care thromboprophylaxis was 97.3% in the high d-dimer cohort, 92.9% in the low d-dimer cohort, and 97.3% in the unknown d-dimer cohort. Major bleeding occurred in 1.9% of the patients receiving therapeutic-dose anticoagulation and in 0.9% of those receiving thromboprophylaxis.ConclusionsIn noncritically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge with reduced use of cardiovascular or respiratory organ support as compared with usual-care thromboprophylaxis. (ATTACC, ACTIV-4a, and REMAP-CAP ClinicalTrials.gov numbers, NCT04372589, NCT04505774, NCT04359277, and NCT02735707.).

Published
2021

19. Trauma-induced coagulopathy

Author

Moore, Ernest E, Moore, Hunter B, Kornblith, Lucy Z, Neal, Matthew D, Hoffman, Maureane, Mutch, Nicola J, Schöchl, Herbert, Hunt, Beverley J, and Sauaia, Angela

Subjects
Hematology, Physical Injury - Accidents and Adverse Effects, Clinical Research, Blood, Cardiovascular, Good Health and Well Being, Blood Coagulation Disorders, Fibrinolysis, Hemorrhage, Hemostasis, Humans, Quality of Life, Clinical Sciences
Abstract

Uncontrolled haemorrhage is a major preventable cause of death in patients with traumatic injury. Trauma-induced coagulopathy (TIC) describes abnormal coagulation processes that are attributable to trauma. In the early hours of TIC development, hypocoagulability is typically present, resulting in bleeding, whereas later TIC is characterized by a hypercoagulable state associated with venous thromboembolism and multiple organ failure. Several pathophysiological mechanisms underlie TIC; tissue injury and shock synergistically provoke endothelial, immune system, platelet and clotting activation, which are accentuated by the 'lethal triad' (coagulopathy, hypothermia and acidosis). Traumatic brain injury also has a distinct role in TIC. Haemostatic abnormalities include fibrinogen depletion, inadequate thrombin generation, impaired platelet function and dysregulated fibrinolysis. Laboratory diagnosis is based on coagulation abnormalities detected by conventional or viscoelastic haemostatic assays; however, it does not always match the clinical condition. Management priorities are stopping blood loss and reversing shock by restoring circulating blood volume, to prevent or reduce the risk of worsening TIC. Various blood products can be used in resuscitation; however, there is no international agreement on the optimal composition of transfusion components. Tranexamic acid is used in pre-hospital settings selectively in the USA and more widely in Europe and other locations. Survivors of TIC experience high rates of morbidity, which affects short-term and long-term quality of life and functional outcome.

Published
2021

23. 36-month clinical outcomes of patients with venous thromboembolism: GARFIELD-VTE

Author

Loualidi, Ab, Colak, Abdurrahim, Bezuidenhout, Abraham, Abdool-Carrim, Abu, Azeddine, Addala, Beyers, Adriaan, Dees, Adriaan, Mohamed, Ahmed, Aksoy, Ahmet, Abiko, Akihiko, Watanabe, Akinori, Krichell, Alan, Fernandez, Alberto Alfredo, Tosetto, Alberto, Khotuntsov, Alexey, Oropallo, Alisha, Slocombe, Alison, Kelly, Allan, Clark, Amanda, Gad, Amr, Arouni, Amy, Schmidt, Andor, Berni, Andrea, Kleiban, Andres Javier, Machowski, Andrew, Kazakov, Andrey, Galvez, Angel, Lockman, Ann, Falanga, Anna, Chauhan, Anoop, Riera-Mestre, Antoni, Mazzone, Antonino, D'Angelo, Armando, Herdy, Artur, Kato, Atsushi, Salem, Ayman Abd Elhamid Ebrahim Mahmoud, Husin, Azlan, Erdelyi, Barbara, Jacobson, Barry, Amann-Vesti, Beatrice, Battaloglu, Bektas, Wilson, Benedicte, Cosmi, Benilde, Francois, Bergmann Jean, Toufek, Berremeli, Hunt, Beverley, Natha, Bhavesh, Mustafa, Bisher, Kho, Bonnie Chi Shan, Carine, Boulon, Zidel, Brian, Dominique, Brisot, Christophe, Brousse, Trimarco, Bruno, Luo, Canhua, Cuneo, Carlos Alberto, Diaz, Carlos Jerjes Sanchez, Schwencke, Carsten, Cader, Cas, Yavuz, Celal, Zaidman, Cesar Javier, Lunn, Charles, Wu, Chau-Chung, Toh, Cheng Hock, Chiang, Chern-En, Elisa, Chevrier, Hsia, Chien-Hsun, Huang, Chien-Lung, Kwok, Chi-Hang Kevin, Wu, Chih-Cheng, Huang, Chi-Hung, Ward, Chris, Opitz, Christian, Jeanneret-Gris, Christina, Ha, Chung Yin, Huang, Chun-Yao, Bidi, Claude Luyeye, Smith, Clifford, Brauer, Cornelia, Lodigiani, Corrado, Francis, Couturaud, Wu, Cynthia, Staub, Daniel, Theodoro, Daniel, Poli, Daniela, Acevedo, David - Riesco, Adler, David, Jimenez, David, Keeling, David, Scott, David, Imberti, Davide, Creagh, Desmond, Helene, Desmurs-Clavel, Hagemann, Dirk, Le Roux, Dirk, Skowasch, Dirk, Belenky, Dmitry, Dorokhov, Dmitry, Petrov, Dmitry, Zateyshchikov, Dmitry, Prisco, Domenico, Møller, Dorthe, Kucera, Dusan, Esheiba, Ehab M., Panchenko, Elizaveta, Dominique, Elkouri, Dogan, Emre, Kubat, Emre, Diaz, Enrique Diaz, Tse, Eric Wai Choi, Yeo, Erik, Hashas, Erman, Grochenig, Ernst, Tiraferri, Eros, Blessing, Erwin, Michèle, Escande Orthlieb, Usandizaga, Esther, Porreca, Ettore, Ferroni, Fabian, Nicolas, Falvo, Ayala-Paredes, Félix, Koura, Firas, Henry, Fitjerald, Cosmi, Franco, Erdkamp, Frans, Kamalov, Gadel, Dalmau, Garcia-Bragado, Damien, Garrigues, Klein, Garry, Shah, Gaurand, Hollanders, Geert, Merli, Geno, Plassmann, Georg, Platt, George, Poirier, Germain, Sokurenko, German, Haddad, Ghassan, Ali, Gholam, Agnelli, Giancarlo, Gan, Gin Gin, Kaye-Eddie, Grace, Le Gal, Gregoire, Allen, Gregory, Esperón, Guillermo Antonio Llamas, Jean-Paul, Guillot, Gerofke, Hagen, Elali, Hallah, Burianova, Hana, Ohler, Hans-Juergen, Wang, Haofu, Darius, Harald, Gogia, Harinder S., Striekwold, Harry, Gibbs, Harry, Hasanoglu, Hatice, Turker, Hatice, Franow, Hendrik, Bounameaux, Henri, De Raedt, Herbert, Schroe, Herman, ElDin, Hesham Salah, Zidan, Hesham, Nakamura, Hiroaki, Kim, Ho Young, Lawall, Holger, Zhu, Hong, Tian, Hongyan, Yhim, Ho-Young, ten Cate, Hugo, Hwang, Hun Gyu, Shim, Hyeok, Kim, Igor, Libov, Igor, Sonkin, Igor, Suchkov, Igor, Song, Ik-Chan, Kiris, Ilker, Staroverov, Ilya, Looi, Irene, De La Azuela Tenorio, Isabel M., Savas, Ismail, Gordeev, Ivan, Podpera, Ivo, Lee, Jae Hoon, Sathar, Jameela, Welker, James, Beyer-Westendorf, Jan, Kvasnicka, Jan, Vanwelden, Jan, Kim, JangYong, Svobodova, Jaromira, Gujral, Jaspal, Marino, Javier, Galvar, Javier Tristan, Kassis, Jeannine, Kuo, Jen-Yuan, Shih, Jhih-Yuan, Kwon, JiHyun, Joh, Jin Hyun, Park, Jin Hyun, Kim, Jin Seok, Yang, Jinghua, Krupicka, Jiri, Lastuvka, Jiri, Pumprla, Jiri, Vesely, Jiri, Souto, Joan Carlos, Correa, João Antônio, Duchateau, Johan, Fletcher, John Perry, del Toro, Jorge, Paez, Jorge Guillermo Chavez, Nielsen, Jørn, Filho, Jose Dalmo Araujo, Saraiva, Jose, Peromingo, Jose Antonio Diaz, Lara, Jose Gomez, Fedele, Jose Luis, Surinach, Jose Maria, Chacko, Joseph, Muntaner, Juan Antonio, Benitez, Juan Carlos Álvarez, Abril, Juan Moreno Hoyos, Humphrey, Julian, Bono, Julio, Kanda, Junji, Boondumrongsagoon, Juree, Yiu, Kai Hang, Chansung, Kanchana, Boomars, Karin, Burbury, Kate, Kondo, Katsuhiro, Karaarslan, Kemal, Takeuchi, Kensuke, Kroeger, Knut, Zrazhevskiy, Konstantin, Svatopluk, Koscál, Shyu, Kou-Gi, Vandenbosch, Kristel, Chang, Kuan-Cheng, Chiu, Kuan-Ming, Jean-Manuel, Kubina, Wern, Kwan Jing, Ueng, Kwo-Chang, Norasetthada, Lalita, Binet, Laure, Chew, Lee Ping, Zhang, Lei, Cristina, Leone Maria, Tick, Lidwine, Schiavi, Lilia Beatriz, Wong, Lily Lee Lee, Borges, Lohana, Botha, Louis, Capiau, Luc, Timmermans, Luc, López, Luciano Eduardo, Ria, Luigi, Blasco, Luis Manuel Hernandez, Guzman, Luis Alberto, Cervera, Luis Flota, Isabelle, Mahe, Bosch, Manuel Monreal, de los Rios Ibarra, Manuel, Fernandez, Manuel Núñez, Carrier, Marc, Barrionuevo, Marcelo Raul, Gamba, Marco Antonio Alcocer, Cattaneo, Marco, Moia, Marco, Bowers, Margaret, Chetanachan, Mariam, Berli, Mario Alberto, Fixley, Mark, Faghih, Markus, Stuecker, Markus, Schul, Marlin, Banyai, Martin, Koretzky, Martin, Myriam, Martin, Gaffney, Mary Elizabeth, Hirano, Masao, Kanemoto, Masashi, Nakamura, Mashio, Tahar, Mersel, Emmanuel, Messas, Kovacs, Michael, Leahy, Michael, Levy, Michael, Munch, Michael, Olsen, Michael, De Pauw, Michel, Gustin, Michel, Van Betsbrugge, Michiel, Boyarkin, Mikhail, Homza, Miroslav, Koto, Modise, Abdool-Gaffar, Mohamed, Nagib, Mohamed Ayman Fakhry, El-Dessoki, Mohamed, Khan, Mohamed, Mohamed, Monniaty, Kim, Moo Hyun, Lee, Moon-Hee, Soliman, Mosaad, Ahmed, Mostafa Shawky, el Bary, Mostafa Soliman Abd, Moustafa, Moustafa A., Hameed, Muhammad, Kanko, Muhip, Majumder, Mujibur, Zubareva, Nadezhda, Mumoli, Nicola, Abdullah, Nik Azim Nik, Makruasi, Nisa, Paruk, Nishen, Kanitsap, Nonglak, Duda, Norberto, Nordin, Nordiana, Nyvad, Ole, Barbarash, Olga, Gurbuz, Orcun, Vilamajo, Oscar Gomez, Flores, Oscar Nandayapa, Gur, Ozcan, Oto, Oztekin, Marchena, Pablo Javier, Angchaisuksiri, Pantep, Carroll, Patrick, Lang, Pavel, MacCallum, Peter, von Bilderling, Peter Baron, Blombery, Peter, Verhamme, Peter, Jansky, Petr, Bernadette, Peuch, De Vleeschauwer, Philippe, Hainaut, Philippe, Ferrini, Piera Maria, Iamsai, Piriyaporn, Christian, Ponchaux, Viboonjuntra, Pongtep, Rojnuckarin, Ponlapat, Ho, Prahlad, Mutirangura, Pramook, Wells, Rachel, Martinez, Rafael, Miranda, Raimundo Tirado, Kroening, Ralf, Ratsela, Rapule, Reyes, Raquel Lopez, de Leon, Raul Franco Diaz, Wong, Raymond Siu Ming, Alikhan, Raz, Jerwan-Keim, Reinhold, Otero, Remedios, Murena-Schmidt, Renate, Canevascini, Reto, Ferkl, Richard, White, Richard, Van Herreweghe, Rika, Santoro, Rita, Klamroth, Robert, Mendes, Robert, Prosecky, Robert, Cappelli, Roberto, Spacek, Rudolf, Singh, Rupesh, Griffin, Sam, Na, Sang Hoon, Chunilal, Sanjeev, Middeldorp, Saskia, Nakazawa, Satoshi, Schellong, Sebastian, Toh, See Guan, Christophe, Seinturier, Isbir, Selim, Raymundo, Selma, Ting, Seng Kiat, Motte, Serge, Aktogu, Serir Ozkan, Donders, Servaas, Cha, Seung Ick, Nam, Seung-Hyun, Marie-Antoinette, Sevestre-Pietri, Maasdorp, Shaun, Sun, Shenghua, Wang, Shenming, Essameldin, Sherif Mohamed, Sholkamy, Sherif Mohamed, Kuki, Shintaro, Goto, Shinya, Yoshida, Shuichi, Matsuoka, Shunzo, McRae, Simon, Watt, Simon, Patanasing, Siriwimon, Jean-Léopold, Siwe-Nana, Wongkhantee, Somchai, Bang, Soo-Mee, Testa, Sophie, Zemek, Stanislav, Behrens, Steffen, Dominique, Stephan, Mellor, Stuart, Singh, Suaran Singh Gurcharan, Datta, Sudip, Chayangsu, Sunee, Solymoss, Susan, Everington, Tamara, Abdel-Azim, Tarek Ahmed Adel, Suwanban, Tawatchai, Adademir, Taylan, Hart, Terence, Béatrice, Terriat, Luvhengo, Thifhelimbilu, Horacek, Thomas, Zeller, Thomas, Boussy, Tim, Reynolds, Tim, Biss, Tina, Chao, Ting-Hsing, Casabella, Tomas Smith, Onodera, Tomoya, Numbenjapon, Tontanai, Gerdes, Victor, Cech, Vladimir, Krasavin, Vladimir, Tolstikhin, Vladimir, Bax, W.A., Malek, Wagih Fawzy Abdel, Ho, Wai Khoon, Ageno, Walter, Pharr, Walter, Jiang, Weihong, Lin, Wei-Hsiang, Zhang, Weihua, Tseng, Wei-Kung, Lai, Wen-Ter, De Backer, Wilfried, Haverkamp, Wilhelm, Yoshida, Winston, Korte, Wolfgang, Choi, Won Il, Kim, Yang-Ki, Tanabe, Yasuhiro, Ohnuma, Yasushi, Mun, Yeung-Chul, Balthazar, Yohan, Park, Yong, Shibata, Yoshisato, Burov, Yuriy, Subbotin, Yuriy, Coufal, Zdenek, Yang, Zhenwen, Jing, Zhicheng, Yang, Zhongqi, Turpie, Alexander G.G., Farjat, Alfredo E., Haas, Sylvia, Weitz, Jeffrey I., Goldhaber, Samuel Z., Kayani, Gloria, Lopes, Renato D., Tse, Eric, Muntaner, Juan, Prandoni, Paolo, Maheshwari, Uma, and Kakkar, Ajay K.

Published
2023
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29. Illustrated State‐of‐the‐Art Capsules of the ISTH 2022 Congress

Author

Ariëns, Robert A., Hunt, Beverley J., Agbani, Ejaife O., Ahnström, Josefin, Ahrends, Robert, Alikhan, Raza, Assinger, Alice, Bagoly, Zsuzsa, Balduini, Alessandra, Barbon, Elena, Barrett, Christopher D., Batty, Paul, Carneiro, Jorge David Aivazoglou, Chan, Wee Shian, de Maat, Moniek, de Wit, Kerstin, Denis, Cécile, Ellis, Martin H., Eslick, Renee, Fu, Hongxia, Hayward, Catherine P.M., Ho‐Tin‐Noé, Benoit, Klok, Frederikus A., Kumar, Riten, Leiderman, Karin, Litvinov, Rustem I., Mackman, Nigel, McQuilten, Zoe, Neal, Matthew D., Parker, William A.E., Preston, Roger J.S., Rayes, Julie, Rezaie, Alireza R., Roberts, Lara N., Rocca, Bianca, Shapiro, Susan, Siegal, Deborah M., Sousa, Lirlândia P., Suzuki‐Inoue, Katsue, Zafar, Tahira, and Zhou, Jiaxi

Published
2022
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30. Diagnostic uncertainty presented barriers to the timely management of acute thrombotic thrombocytopenic purpura in the United Kingdom between 2014 and 2019

Author

Bull, Tom P., McCulloch, Rory, Nicolson, Phillip L.R., Doyle, Andrew J., Shaw, Rebecca J., Langridge, Alexander, Sayar, Zara, Tucker, David L., Pettit, Michala, Perry, Rita, Thomas, William, Page, Catherine, Whalley, Ioana, Dutt, Tina, Garth, Louise, Lester, Will, Buka, Richard J., Subhan, Mary, Ware, Victoria, Rayment, Rachel, Castle, Daniel, Etherington, Astrid, Carter‐Brzezinski, Luke, Peters, Jayne, Corrigan, Claire, Sharma, Narind, Benson, Gary, Challenor, Sarah, Skinner, Thomas S., Zhao, Rui, McLeod‐Kennedy, Lyndsay A.G., Douglas, Kenneth, Knott, Amy, Smith, Sophie, Wolf, Julia, Todd, Sophie A., McDonald, Vickie, Rampotas, Alexandros, Dean, Christopher, Sangha, Gavinda, Pavord, Sue, Denny, Nicholas, Jaafar, Sarah, McLaughlin, David P.T., Ross, Jennifer E., Karanth, Mamatha, Beverstock, Sarah L., Mansonso, Lynn, Burrows, Samuel H., Tauro, Sudhir, Shenouda, Amir, Bailiff, Benjamin M., Kajita, Daniel, Hermans, Joannes, Goradia, Harshita, Finan, Emily M., Alford, Sarah, Pickard, Keir, Greystoke, Brigit, Fail, Thomas, Abdussalam, Asmaa, Roberts, Lara N, Clark, James B., Heeney, Natalie, Young, Jennifer, Maddox, Jamie, Srinath, Swathy, Khawaja, Jahanzeb, Parkes, Jayne, Babiker, Samah, Hunt, Beverley J., Wheeldon, Sarah L., Kerr, Paul, Tahhan, Molham, Vickers, Mark, Pike, Alexandra C., Hill, Quentin, Mustafa, Nadreen, Almaremi, Azza, Hughes, Emily, McGoldrick, Sean J.F., Loizou, Eleana, James, Izabela, Boyce, Sara R., Farmer, Isabel, Thanigaikumar, Murugaiyan, Wickenden, Katherine, Gooding, Richard, Thornton, Kathryn, Kane, Clare, Cole, Adam, Griffin, JessicaC, Docherty, Suzanne, Dixon, Kiri I., Crowe, Josephine, Sheridan, Mathew, De Lord, Corinne, Sud, Amit, Austin, Anna, Coooper, Nichola, Bailey, Chris, Attwell, Luke, Hall, Rachel, Gray, Benjamin, Chauhan, Salena R., Lokare, Anand, Gudger, Amy, Horgan, Claire, Venkatadasari, Indrani, Kaddam, Israa, Mapplebeck, Claire L., Van Veen, Joost, Raj, Maya, De Abrew, Kanchana, Belsham, Edward, Gyansah, Cecilia, Sadullah, Shalal, Salhan, Beena, Murrin, Richard, Williams, Rhys L., Stewart, Andrew, Cornish, Naomi, Otton, Sophie, Khan, Zeeshan, Ackroyd, Sam, Chen, Lucia Y., Lafferty, Nicholas P., Leonforte, Francesca, Pemberton, Nicholas, Rawi, Emanal, Triantafyllopoulou, Diana, Adiyodi, Jagdish, Yong, Jun, Jones, Elizabeth, Davies, David, Peck, Rachel C., Philip, Robson, Seddon, Thomas, Cahalin, Paul, Prodger, Catherine, Dutton, David A., Sternberg, Alexander J., Chengal, Rajani, Polzella, Paolo, and Scully, Marie

Published
2022
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33. Clinical outcomes of patients receiving long-term fondaparinux for thrombotic antiphospholipid syndrome.

Author

Bor, Buse, Doyle, Andrew J, Bartoli-Abdou, John K, Hackett, Anthony, Collings, Victoria, Omrani, Fatima, Foskett, Carl, Wareing, Anne, Young, Johanna, Breen, Karen A, and Hunt, Beverley J

Subjects
ANTIPHOSPHOLIPID syndrome, ELECTRONIC records, LOGISTIC regression analysis, MEDICAL records, TREATMENT effectiveness
Abstract

Introduction: Vitamin-K antagonists (VKA) are considered the first-line anticoagulants for thrombotic antiphospholipid syndrome (TAPS), particularly with triple positivity or arterial events. However, thrombotic recurrence remains high despite anticoagulation and other clinical issues may arise. Long-term parenteral anticoagulants may therefore be considered, however little is known about the viability of fondaparinux in this setting. Materials and Methods: We describe the efficacy and safety of long-term fondaparinux for TAPS (>3-months duration) treated at a single centre in the UK. Clinical features and the outcomes of recurrence and bleeding were reviewed using electronic patient records. Results: 46 patients were identified with history of either venous or arterial TAPS and a total 175 patient-years using fondaparinux (median duration 2.7 years/patient (IQR 1.4–4.8)). 43 (93%) had VKA as first-line anticoagulation with a median duration of 6.5 years (IQR 4.0 – 9.8). All patients received fondaparinux as second-to fourth-line anticoagulation. Thrombosis recurrence occurred in 1 (1%) patient (0.6 events/100-patient years). Major, clinically relevant non-major (CRNM) or minor bleeding occurred in 2 (7%), 5 (10.9%) and 8 (17.4%) patients respectively. Major/CRNM bleeding rates were 1.1 and 2.9 events/100-patient-years. Age >65years was associated with bleeding (p =.047) and concurrent antiplatelets were associated with major/CRNM bleeding (p =.011). Logistic regression showed increasing age was associated with bleeding (OR = 1.097, p =.009). Conclusions: We suggest that fondaparinux may be used for TAPS when VKA is not appropriate. Thrombotic recurrence was infrequent, and the number of major bleeding events appeared comparable to conventional therapies. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Standardized Data Elements for Patients With Acute Pulmonary Embolism: A Consensus Report From the Pulmonary Embolism Research Collaborative.

Author

Rosenfield, Kenneth, Bowers, Terry R., Barnett, Christopher F., Davis, George A., Giri, Jay, Horowitz, James M., Huisman, Menno V., Hunt, Beverley J., Keeling, Brent, Kline, Jeffrey A., Klok, Frederikus A., Konstantinides, Stavros V., Lanno, Michelle T., Lookstein, Robert, Moriarty, John M., Áinle, Fionnuala Ní, Reed, Jamie L., Rosovsky, Rachel P., Royce, Sara M., and Secemsky, Eric A.

Published
2024
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36. Current practices of standardized risk assessment for venous thromboembolism: Results from a global survey from the World Thrombosis Day steering committee

Author

Wendelboe, Aaron M., Langenfeld, Hannah, Ageno, Walter, Castellucci, Lana, Cesarman‐Maus, Gabriela, Ddungu, Henry, De Paula, Erich Vinicius, Dumantepe, Mert, Forgo, Gabor, Guillermo Esposito, Maria Cecilia, McLintock, Claire, Ní Áinle, Fionnuala, Spyropoulos, Alex C., Urano, Tetsumei, Barco, Stefano, and Hunt, Beverley J.

Published
2022
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37. An update on the global use of risk assessment models and thromboprophylaxis in hospitalized patients with medical illnesses from the World Thrombosis Day steering committee: Systematic review and meta‐analysis

Author

Forgo, Gabor, Micieli, Evy, Ageno, Walter, Castellucci, Lana A., Cesarman‐Maus, Gabriela, Ddungu, Henry, De Paula, Erich Vinicius, Dumantepe, Mert, Guillermo Esposito, Maria Cecilia, Konstantinides, Stavros V., Kucher, Nils, McLintock, Claire, Ní Áinle, Fionnuala, Spyropoulos, Alex C., Urano, Tetsumei, Hunt, Beverley J., and Barco, Stefano

Published
2022
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43. Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

Author

Vlaar, Alexander P. J., Dionne, Joanna C., de Bruin, Sanne, Wijnberge, Marije, Raasveld, S. Jorinde, van Baarle, Frank E. H. P., Antonelli, Massimo, Aubron, Cecile, Duranteau, Jacques, Juffermans, Nicole P., Meier, Jens, Murphy, Gavin J., Abbasciano, Riccardo, Müller, Marcella C. A., Lance, Marcus, Nielsen, Nathan D., Schöchl, Herbert, Hunt, Beverley J., Cecconi, Maurizio, and Oczkowski, Simon

Published
2021
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44. Global reporting of pulmonary embolism–related deaths in the World Health Organization mortality database: Vital registration data from 123 countries

Author

Barco, Stefano, Valerio, Luca, Gallo, Andrea, Turatti, Giacomo, Mahmoudpour, Seyed Hamidreza, Ageno, Walter, Castellucci, Lana A., Cesarman‐Maus, Gabriela, Ddungu, Henry, De Paula, Erich Vinicius, Dumantepe, Mert, Goldhaber, Samuel Z., Guillermo Esposito, Maria Cecilia, Klok, Frederikus A., Kucher, Nils, McLintock, Claire, Ní Áinle, Fionnuala, Simioni, Paolo, Spirk, David, Spyropoulos, Alex C., Urano, Tetsumei, Zhai, Zhen‐guo, Hunt, Beverley J., and Konstantinides, Stavros V.

Published
2021
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48. Age-sex specific pulmonary embolism-related mortality in the USA and Canada, 2000–18: an analysis of the WHO Mortality Database and of the CDC Multiple Cause of Death database

Author

Barco, Stefano, Valerio, Luca, Ageno, Walter, Cohen, Alexander T, Goldhaber, Samuel Z, Hunt, Beverley J, Iorio, Alfonso, Jimenez, David, Klok, Frederikus A, Kucher, Nils, Mahmoudpour, Seyed Hamidreza, Middeldorp, Saskia, Münzel, Thomas, Tagalakis, Vicky, Wendelboe, Aaron M, and Konstantinides, Stavros V

Published
2021
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49. Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis

Author

Kakkos, Stavros K., Gohel, Manjit, Baekgaard, Niels, Bauersachs, Rupert, Bellmunt-Montoya, Sergi, Black, Stephen A., ten Cate-Hoek, Arina J., Elalamy, Ismail, Enzmann, Florian K., Geroulakos, George, Gottsäter, Anders, Hunt, Beverley J., Mansilha, Armando, Nicolaides, Andrew N., Sandset, Per Morten, Stansby, Gerard, ESVS Guidelines Committee, de Borst, Gert J., Bastos Gonçalves, Frederico, Chakfé, Nabil, Hinchliffe, Robert, Kolh, Philippe, Koncar, Igor, Lindholt, Jes S., Tulamo, Riikka, Twine, Christopher P., Vermassen, Frank, Wanhainen, Anders, Document reviewers, De Maeseneer, Marianne G., Comerota, Anthony J., Gloviczki, Peter, Kruip, Marieke J.H.A., Monreal, Manuel, Prandoni, Paolo, and Vega de Ceniga, Melina

Published
2021
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50. Heparin Dose Intensity and Organ Support-Free Days in Patients Hospitalized for COVID-19

Author

Medische Staf Intensive Care, Infection & Immunity, Godoy, Lucas C., Neal, Matthew D., Goligher, Ewan C., Cushman, Mary, Houston, Brett L., Bradbury, Charlotte A., McQuilten, Zoe K., Tritschler, Tobias, Kahn, Susan R., Berry, Lindsay R., Lorenzi, Elizabeth, Jensen, Tom, Higgins, Alisa M., Kornblith, Lucy Z., Berger, Jeffrey S., Gong, Michelle N., Paul, Jonathan D., Castellucci, Lana A., Le Gal, Grégoire, Lother, Sylvain A., Rosenson, Robert S., Derde, Lennie P.G., Kumar, Anand, McVerry, Bryan J., Nicolau, Jose C., Leifer, Eric, Escobedo, Jorge, Huang, David T., Reynolds, Harmony R., Carrier, Marc, Kim, Keri S., Hunt, Beverley J., Slutsky, Arthur S., Turgeon, Alexis F., Webb, Steven A., McArthur, Colin J., Farkouh, Michael E., Hochman, Judith S., Zarychanski, Ryan, Lawler, Patrick R., Medische Staf Intensive Care, Infection & Immunity, Godoy, Lucas C., Neal, Matthew D., Goligher, Ewan C., Cushman, Mary, Houston, Brett L., Bradbury, Charlotte A., McQuilten, Zoe K., Tritschler, Tobias, Kahn, Susan R., Berry, Lindsay R., Lorenzi, Elizabeth, Jensen, Tom, Higgins, Alisa M., Kornblith, Lucy Z., Berger, Jeffrey S., Gong, Michelle N., Paul, Jonathan D., Castellucci, Lana A., Le Gal, Grégoire, Lother, Sylvain A., Rosenson, Robert S., Derde, Lennie P.G., Kumar, Anand, McVerry, Bryan J., Nicolau, Jose C., Leifer, Eric, Escobedo, Jorge, Huang, David T., Reynolds, Harmony R., Carrier, Marc, Kim, Keri S., Hunt, Beverley J., Slutsky, Arthur S., Turgeon, Alexis F., Webb, Steven A., McArthur, Colin J., Farkouh, Michael E., Hochman, Judith S., Zarychanski, Ryan, and Lawler, Patrick R.

Published
2024

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