Timing of Chemical Anticoagulant Administration in Spine Trauma and its Impact on VTE, Bleeding, and Mortality: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Study Design Systematic review and meta-analysis. Objective To evaluate the timing of anticoagulation in acute spinal trauma, specifically assessing the efficacy and safety of early (<48 hours) vs delayed administration for chemical venous thromboembolism prophylaxis. Methods A systematic search of Medline, EMBASE, Web of Science, and Cochrane was conducted through February 2023 for studies comparing early vs delayed anticoagulation in acute spinal trauma patients. Studies reporting deep vein thrombosis (DVT), pulmonary embolism (PE), major bleeding, and mortality were included. Three reviewers independently screened and extracted data. Risk of bias was assessed using MINORS and the Newcastle-Ottawa Scale. The protocol was registered on PROSPERO (CRD42023397717). Results Five studies, comprising a total of 13,110 patients, compared anticoagulant administration within 48 hours of trauma vs after 48 hours, reporting DVT and PE as outcomes. Early administration was associated with significantly lower odds of DVT (OR: 0.20 [95% CI: 0.17-0.25], P = .0001, I 2 = 34%) and PE (OR: 0.46 [95% CI: 0.34-0.62], P = .0001, I 2 = 0%). Four studies evaluated major bleeding as an outcome and found slightly lower odds with early initiation, though the association was not statistically significant (OR: 0.85 [95% CI: 0.66-1.09], P = .1992). Similarly, 4 studies assessed mortality, with results that were also nonsignificant. Conclusions The current evidence indicates that early initiation of chemical anticoagulation within 48 hours of injury in spine trauma patients is associated with favorable outcomes in preventing thromboembolic complications, without significantly increasing the risk of bleeding or mortality.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.015 | 0.037 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.027 | 0.044 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".