Prevention of Venous Thromboembolism in Major Orthopedic Surgery: Bayesian Network Meta-Analysis of 21 Randomized Trials Evaluating Unfractionated Heparins, LowMolecular Weight Heparins, and New Oral Anticoagulants

Prevention of Venous Thromboembolism in Major Orthopedic Surgery: Bayesian Network Meta-Analysis of 21 Randomized Trials Evaluating Unfractionated Heparins, LowMolecular Weight Heparins, and New Oral Anticoagulants

Objective: In major orthopedic surgery, the prevention of venous thromboembolism has been based, over the past decades, on unfractionated heparins (UFHs), then on low-molecular weight heparins (LMWHs) and, more recently, on new oral anticoagulants (NOACs). To summarize the comparative effectiveness of UFHs, LMWHs, and NOACs in this clinical indication, we applied Bayesian network meta-analysis to the clinical material (randomized studies) published in two previous reviews focused on this issue. Our endpoint was a composite of venous thromboembolism and pulmonary embolism.

Methods: Our analysis was based on standard Bayesian network meta-analysis (random-effect model).