LEADER 00870nam 2200325 450 001 990001040090203316 035 $a0104009 035 $aUSA010104009 035 $a(ALEPH)000104009USA01 035 $a0104009 100 $a20020318d--------km-y0itay0103----ba 101 $aeng 102 $aGB 110 $aaca-------- 200 1 $a<> Listener 210 $aLondon 215 $av$d31 cm 326 $aSettimanale 410 $12001 606 0 $aGran Bretagna$xVita artistica e culturale$xPeriodici 676 $a791.4 801 0$aIT$bsalbc$gISBD 912 $a990001040090203316 958 $aUMA$c53(1955)-123(1990) ; scompleti 1970-1971, 1976, 1978, 1980 959 $aSE 979 $aPATTY$b90$c20020318$lUSA01$h1600 979 $c20020403$lUSA01$h1744 979 $aPATRY$b90$c20040406$lUSA01$h1712 996 $aListener$9976672 997 $aUNISA LEADER 00891nam0-22003251i-450- 001 990007098100403321 005 20041203092024.0 010 $a88-15-07814-2 035 $a000709810 035 $aFED01000709810 035 $a(Aleph)000709810FED01 035 $a000709810 100 $a20020625d2000----km-y0itay50------ba 101 $aita 102 $aIT 105 $ab---a---001cy 200 1 $a<>Piave$fFortunato Minniti 210 $aBologna$cil Mulino$d©2000 215 $a148 p.$cill.$d21 cm 225 1 $a<>identità italiana$v20 610 0 $aPrima guerra mondiale - Italia - Caporetto - Piave 676 $a940.43$v21$zita 700 1$aMinniti,$bFortunato$0261294 801 0$aIT$bUNINA$gRICA$2UNIMARC 901 $aBK 912 $a990007098100403321 952 $a940.43 MIN 1$bBibl. 41372$fFLFBC 959 $aFLFBC 996 $aPiave$964119 997 $aUNINA LEADER 05061nam 2200445 450 001 9910717369703321 005 20221025172116.0 035 $a(CKB)2670000000429635 035 $a(NjHacI)992670000000429635 035 $a(OCoLC)847111323$z(OCoLC)1118518486 035 $a(EXLCZ)992670000000429635 100 $a20221025d2012 uy 0 101 0 $aeng 135 $aur||||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 10$aComparative effectiveness of newer oral anticoagulants and standard anticoagulant regimens for thromboprophylaxis in patients undergoing total hip or knee replacement /$fSoheir S Adam [and four others] 210 1$aWashington, District of Columbia :$cDepartment of Veterans Affairs (US),$d[2012] 210 4$d©2012 215 $a1 online resource (iii, 59 pages) $cillustrations 300 $a"Evidence-based synthesis program." 300 $a"December 2012." 320 $aIncludes bibliographical references. 330 3 $aVenous thromboembolic (VTE) events are important causes of morbidity in elective total hip replacement (THR) and total knee replacement (TKR) procedures. Current guidelines recommend thromboprophylaxis in patients undergoing THR or TKR, although the American Academy of Orthopaedic Surgeons (AAOS) guidelines suggest individual assessment of patients when choosing the specific thromboprophylaxis strategy. Low molecular weight heparin (LMWH) and adjusted-dose warfarin are the most commonly used anticoagulants for thromboprophylaxis in the United States, but a number of other treatment options are available, including unfractionated heparin, aspirin, mechanical devices, and newer oral anticoagulants.^Prior to 1980, rates of symptomatic VTE were 15 to 30 percent.^However, improved surgical care and techniques have decreased the rate of symptomatic VTE.^A recent analysis that incorporated data from trials and observational studies estimated the contemporary 35-day rate of symptomatic VTE without thromboprophylaxis at 4.3 percent. Pharmacological thromboprophylaxis for THR or TKR surgery decreases VTE by approximately 50 percent but with the tradeoff of increased bleeding. The risk of bleeding is a concern because bleeding can lead to infections, reoperation, delayed wound healing, and extended hospital stay. The choice of which antithrombotic thus becomes pivotal for balancing the prevention of thromboembolism with the risk of bleeding.^Newer oral anticoagulants have been developed with the goal of overcoming the limitations of warfarin and the available parenteral agents.^These newer anticoagulants belong to two drug classes, based on their target coagulation protein: factor Xa (FXa) inhibitors and direct thrombin inhibitors (DTIs).^These drugs are given as fixed oral doses and have the advantage of a more predictable anticoagulant effect, eliminating the need for monitoring when used for short-term thromboprophylaxis. Disadvantages of newer oral anticoagulants include the lack of specific antidotes to reverse their anticoagulant effect in a timely fashion in case of bleeding, and drug costs. Given the emerging data on new oral anticoagulants, this report was commissioned by the VA to examine the following key questions (KQs):1.^KQ 1.^For patients undergoing total hip or total knee replacement, what is the comparative effectiveness of newer oral anticoagulants and standard drug classes (low molecular weight heparin, injectable factor Xa inhibitors, unfractionated heparin, warfarin, aspirin) on the incidence of symptomatic, objectively confirmed venous thromboembolism (VTE), other VTE events, total mortality, and bleeding outcomes?2. KQ2.^For patients undergoing total hip or total knee replacement, what are the effects of combined pharmacological and mechanical modalities versus pharmacological treatment alone on the incidence of symptomatic, objectively confirmed VTE, other VTE events, total mortality, and bleeding outcomes?3. KQ3. For patients undergoing total hip or total knee replacement, what is the comparative efficacy of individual newer oral anticoagulants on the incidence of symptomatic, objectively confirmed VTE, other VTE events, total mortality, and bleeding outcomes? 606 $aAnticoagulants (Medicine) 607 $aUnited States$2fast 615 0$aAnticoagulants (Medicine) 676 $a615.718 700 $aAdam$b Soheir S.$01353454 712 02$aUnited States.$bDepartment of Veterans Affairs.$bHealth Services Research and Development Service, 712 02$aDurham VA Medical Center.$bEvidence-based Synthesis Program Center. 712 02$aQuality Enhancement Research Initiative (U.S.) 712 02$aEvidence-based Synthesis Program (U.S.) 801 0$bNjHacI 801 1$bNjHacl 906 $aBOOK 912 $a9910717369703321 996 $aComparative effectiveness of newer oral anticoagulants and standard anticoagulant regimens for thromboprophylaxis in patients undergoing total hip or knee replacement$93254402 997 $aUNINA