Efficacy and safety of extended duration postoperative thromboprophylaxis with low molecular weight heparin among subgroups of patients undergoing surgical resection of colorectal cancer: A post-hoc analysis of the PERIOP-01 trial
Bibliographic record
Abstract
BACKGROUND: Extended duration postoperative thromboprophylaxis is suggested by clinical practice guidelines after any cancer-related major abdominal surgeries. However, recent evidence reported relatively low rates of symptomatic venous thromboembolism (VTE) after colorectal cancer surgeries, suggesting the need of a careful risk-benefit assessment in this setting. METHODS: This is a pre-planned post-hoc analysis of the PERIOP-01 trial which compared extended to standard thromboprophylaxis in patients undergoing surgical resection of localized colorectal cancer. Subgroup analyses were performed based on different baseline characteristics. The primary efficacy and safety outcomes were major VTE and clinically relevant bleeding events, respectively. RESULTS: A total of 614 patients were included in the modified intention-to-treat analysis (307 patients in each group). Major VTE events occurred in 2 % and 1 % of the extended and standard-duration thromboprophylaxis groups, respectively. Clinically relevant bleeding events occurred in 3 % of each group. No specific characteristics were found to be associated with a decreased incidence of major VTE among patients receiving extended thromboprophylaxis. Patients with colon cancer resection receiving extended thromboprophylaxis were at an increased risk of clinically relevant bleeding (HR 2.57, 95%CI 1.25-5.30). Other characteristics that may be associated with an increased incidence of bleeding included age (≥75) (HR 2.37, 95%CI 0.47-11.98) and sex (HR 2.13, 95%CI 0.20-23.17). CONCLUSIONS: In the PERIOP-01 trial, extended thromboprophylaxis did not reduce the incidence of major VTE in any subgroups of patients. However, this strategy may be associated with an increased incidence of bleeding among patients with colon cancer, and perhaps among male and elderly patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".