{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:02:50Z","timestamp":1788447770336,"version":"build-2803163510"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The efficacy and safety of pharmacological thromboprophylaxis in patients with intracerebral hemorrhage (ICH) remains unclear.<\/jats:p><jats:p>\n          Methods\u2003A literature search was performed to collect studies comparing the effect of thromboprophylaxis in patients with ICH. The primary endpoints were deep vein thrombosis (DVT), pulmonary embolism (PE), and hematoma expansion or rebleeding. A meta-analytic approach was employed to estimate the relative risk (RR) by fitting fixed-effects (FE) and random-effects (RE) models.<\/jats:p><jats:p>\n          Results\u2003A total of 28 studies representing 3,697 hospitalized patients with ICH were included. Thromboprophylaxis was initiated within 4 days following hospital presentation and continued for 10 to 14 days in most of studies. Compared with control, thromboprophylaxis was associated with a reduced risk of DVT (47\/1,399 [3.4%] vs. 202\/1,377 [14.7%]; FE: RR, 0.24; 95% CI, 0.18\u20130.32; RE: RR, 0.27; 95% CI, 0.19\u20130.39) as well as PE (9\/953 [0.9%] vs. 37\/864 [4.3%]; FE: RR, 0.33; 95% CI, 0.19\u20130.57; RE: RR, 0.37; 95% CI, 0.21\u20130.66). Thromboprophylaxis was not associated with increased risk of hematoma expansion or rebleeding (32\/1,319 [2.4%] vs. 37\/1,301 [2.8%]; FE: RR, 0.75; 95% CI, 0.48\u20131.18; RE: RR, 0.80; 95% CI, 0.49\u20131.30) or mortality (117\/925 [12.6%] vs. 139\/904 [15.4%]; FE: RR, 0.82; 95% CI, 0.65\u20131.03; RE: RR, 0.83; 95% CI, 0.66\u20131.04).<\/jats:p><jats:p>\n          Conclusion\u2003Thromboprophylaxis was effective in preventing DVT and PE without increasing the risk of hematoma expansion or bleeding among ICH patients. Future studies should explore the long-term effects of thromboprophylaxis in this population, particularly on the functional outcomes.<\/jats:p>","DOI":"10.1055\/s-0042-1744541","type":"journal-article","created":{"date-parts":[[2022,6,19]],"date-time":"2022-06-19T22:30:34Z","timestamp":1655677834000},"page":"1159-1168","source":"Crossref","is-referenced-by-count":17,"title":["Systematic Review and Meta-Analysis of Thromboprophylaxis with Heparins Following Intracerebral Hemorrhage"],"prefix":"10.1055","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-1689","authenticated-orcid":false,"given":"Gerald","family":"Chi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Trial Design and Development, Baim Institute for Clinical Research, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Marszalek","sequence":"additional","affiliation":[{"name":"Department of Neurology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United 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anticoagulants in the prevention of venous thromboembolism in patients with acute cerebral hemorrhage: a meta-analysis of controlled studies","volume":"9","author":"M Paciaroni","year":"2011","journal-title":"J Thromb Haemost"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/neuros\/nyx146","article-title":"Current practice trends for use of early venous thromboembolism prophylaxis after intracerebral hemorrhage","volume":"82","author":"L J Cherian","year":"2018","journal-title":"Neurosurgery"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1161\/STROKEAHA.114.008006","article-title":"Is prophylactic anticoagulation for deep venous thrombosis common practice after intracerebral hemorrhage?","volume":"46","author":"S Prabhakaran","year":"2015","journal-title":"Stroke"},{"issue":"71","key":"ref6","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"J AC Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"J A Sterne","year":"2016","journal-title":"BMJ"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"L A McGuinness","year":"2021","journal-title":"Res Synth Methods"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1080\/17474086.2017.1343662","article-title":"The risk of stroke among acutely ill hospitalized medical patients: lessons from recent trials on extended-duration thromboprophylaxis","volume":"10","author":"J Marszalek","year":"2017","journal-title":"Expert Rev Hematol"},{"issue":"04","key":"ref11","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"N Mantel","year":"1959","journal-title":"J Natl Cancer Inst"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"197","DOI":"10.6028\/jres.094.020","article-title":"Consensus values, regressions, and weighting factors","volume":"94","author":"R C Paule","year":"1989","journal-title":"J Res Natl Inst Stand Technol"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1467-985X.2008.00552.x","article-title":"A re-evaluation of random-effects meta-analysis","volume":"172","author":"J P Higgins","year":"2009","journal-title":"J R Stat Soc Ser A Stat Soc"},{"issue":"11","key":"ref14","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"J P Higgins","year":"2002","journal-title":"Stat Med"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"M Egger","year":"1997","journal-title":"BMJ"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.jclinepi.2007.11.010","article-title":"Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry","volume":"61","author":"J L Peters","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"ref17","first-page":"9","volume-title":"Package \u2018meta\u2019","author":"G Schwarzer","year":"2012"},{"issue":"23","key":"ref18","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1007\/BF01727666","article-title":"Heparin therapy, deep-vein thrombosis and pulmonary embolism after intracerebral hemorrhage","volume":"66","author":"U Dickmann","year":"1988","journal-title":"Klin Wochenschr"},{"issue":"07","key":"ref19","first-page":"362","article-title":"A non-randomized study of safety and efficacy of heparin for DVT prophylaxis in intracerebral haemorrhage","volume":"58","author":"M Wasay","year":"2008","journal-title":"J Pak Med Assoc"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/S1474-4422(21)00075-2","article-title":"Risks of recurrent stroke and all serious vascular events after spontaneous intracerebral haemorrhage: pooled analyses of two population-based studies","volume":"20","author":"L Li","year":"2021","journal-title":"Lancet Neurol"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1161\/STROKEAHA.116.016327","article-title":"Restarting anticoagulant therapy after intracranial hemorrhage: a systematic review and meta-analysis","volume":"48","author":"S B Murthy","year":"2017","journal-title":"Stroke"},{"issue":"10","key":"ref22","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/S1474-4422(21)00264-7","article-title":"Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial","volume":"20","author":"S C So","year":"2021","journal-title":"Lancet Neurol"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"105476","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105476","article-title":"Ultra-early venous thromboembolism (VTE) prophylaxis in spontaneous intracerebral hemorrhage (sICH)","volume":"30","author":"M F Kananeh","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"8","DOI":"10.7326\/0003-4819-153-1-201007060-00004","article-title":"Extended-duration venous thromboembolism prophylaxis in acutely ill medical patients with recently reduced mobility: a randomized trial","volume":"153","author":"R D Hull","year":"2010","journal-title":"Ann Intern Med"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"953","DOI":"10.3171\/jns.2003.99.6.0953","article-title":"No effect of enoxaparin on outcome of aneurysmal subarachnoid hemorrhage: a randomized, double-blind, placebo-controlled clinical trial","volume":"99","author":"J Siironen","year":"2003","journal-title":"J Neurosurg"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.clineuro.2004.01.006","article-title":"Reduction of ischemic sequelae following spontaneous subarachnoid hemorrhage: a double-blind, randomized comparison of enoxaparin versus placebo","volume":"106","author":"G Wurm","year":"2004","journal-title":"Clin Neurol Neurosurg"}],"container-title":["Thrombosis and 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