Table 84Strength of evidence for final, intermediate and adverse outcomes comparing enoxaparin prophylaxis to other low molecular weight heparin agents in patients who had major orthopedic surgery

Quality AssessmentSummary of Findings
OutcomeNumber of studiesDesignRisk of BiasConsistencyDirectnessPrecisionQuality
Symptomatic objectively confirmed VTE0---------------Insufficient
Major VTE0---------------Insufficient
Pulmonary Embolism1RCTSerious limitationNANo indirectnessNAInsufficient
Fatal pulmonary embolism2RCTNo limitationsNANo indirectnessVery serious imprecisionInsufficient
Nonfatal pulmonary embolism2RCTNo limitationsNANo indirectnessVery serious imprecisionInsufficient
Post thrombotic syndrome0---------------Insufficient
Mortality1RCTNo limitationsNANo indirectnessVery serious imprecisionInsufficient
Mortality due to bleeding1RCTNo limitationsNANo indirectnessNAInsufficient
Health related quality of life0---------------Insufficient
Deep vein thrombosis2RCTNo limitationsSerious inconsistencyNo indirectnessSerious imprecisionLow
Asymptomatic deep vein thrombosis1RCTSerious limitationNANo indirectnessSerious imprecisionInsufficient
Symptomatic deep vein thrombosis2RCTNo limitationsNANo indirectnessSerious imprecisionInsufficient
Proximal deep vein thrombosis2RCTNo limitationsSerious inconsistencyNo indirectnessSerious imprecisionLow
Distal deep vein thrombosis1RCTNo limitationsNANo indirectnessNo imprecisionInsufficient
Major bleeding2RCTNo limitationsNo inconsistencyNo indirectnessSerious imprecisionModerate
Major bleeding leading to reoperation0---------------Insufficient
Minor bleeding1RCTNo limitationsNANo indirectnessSerious imprecisionInsufficient
Surgical site bleeding2RCTNo limitationsNo inconsistencyNo indirectnessVery serious imprecisionLow
Bleeding leading to infection0---------------Insufficient
Bleeding leading to transfusion0RCTNo limitationsNANo indirectnessVery serious imprecisionInsufficient
Heparin-induced thrombocytopenia1---------------Insufficient
Discomfort0---------------Insufficient
Readmission0---------------Insufficient
Reoperation0---------------Insufficient

Abbreviations: NA=not applicable; RCT=randomized controlled trial; VTE=venous thromboembolism

From: Appendix H, Strength of Evidence Rating

Cover of Venous Thromboembolism Prophylaxis in Orthopedic Surgery
Venous Thromboembolism Prophylaxis in Orthopedic Surgery [Internet].
Comparative Effectiveness Reviews, No. 49.
Sobieraj DM, Coleman CI, Tongbram V, et al.

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