Dataset Information

Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol.

ABSTRACT: INTRODUCTION:In recent years, a hypothesis has been raised that people with tuberculosis are at risk for developing venous thromboembolism (VTE). However, much remains to be understood about the interplay between VTE and tuberculosis. Therefore, through a global systematic review and meta-analysis, the current study aims at investigating the association between exposure to active tuberculosis and risk of VTE, and determining the prevalence and incidence of VTE in people with active tuberculosis. METHODS AND DESIGN:We will include cohort studies, case-control and cross-sectional studies performed among adults (>15 years) with active tuberculosis. EMBASE, Medline, Global Index Medicus and Web of Knowledge will be searched for relevant records published until 31 August 2019, without any language restriction. The review will be reported according to the Meta-analysis Of Observational Studies in Epidemiology guidelines. After screening of titles and abstracts, study selection, data extraction and risk of bias assessment; we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Egger's test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region. ETHICS AND DISSEMINATION:Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the epidemiology of VTE in people with tuberculosis. The final report will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER:CRD42019130347.

SUBMITTER: Awana PA

PROVIDER: S-EPMC6858194 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol.

Awana Philippe Armel PA Danwang Celestin C Tochie Joel Noutakdie JN Bigna Jean Joel JJ

BMJ open 20191112 11

<h4>Introduction</h4>In recent years, a hypothesis has been raised that people with tuberculosis are at risk for developing venous thromboembolism (VTE). However, much remains to be understood about the interplay between VTE and tuberculosis. Therefore, through a global systematic review and meta-analysis, the current study aims at investigating the association between exposure to active tuberculosis and risk of VTE, and determining the prevalence and incidence of VTE in people with active tuber ...[more]

PMID: 31722945

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Project description:INTRODUCTION:Obesity is significant risk factor for venous thromboembolism (VTE); however, the related mechanisms remain unclear. Previous studies have suggested that this might be related to physical factors including anthropometric measures. We intend to conduct a systematic review and meta-analysis of prospective studies to summarise the extant literature on the associations between a set of seven measures of body size and the risk of VTE. METHODS AND ANALYSIS:The current systematic review will include prospective cohort studies assessing the association between seven measures of body size (height, weight, body mass index, waist and hip circumferences, waist-to-hip ratio, waist-to-height ratio) and the risk of VTE. We will conduct comprehensive searches of MEDLINE and Excerpta Medica Database (EMBASE) for articles published from inception through 31 August 2017, without any language restriction. Two investigators will independently screen, select studies and perform data extraction and risk of bias assessment, with discrepancies resolved by a third investigator. For each body size measure, study-specific relative risks will be pooled using random effects meta-analysis models. Statistical heterogeneity will be assessed using Cochran's Q statistic, H and the I2 statistics. Sources of heterogeneity will be investigated using subgroup and meta-regression analyses as deemed appropriate. Publication bias will be assessed with funnel plots supplemented by Egger's test. ETHICS AND DISSEMINATION:This systematic review will use data from published literature; therefore, ethical approval is not required. We expect our findings to supplement previous epidemiological studies by providing an updated and comprehensive synthesis of the available evidence on the association between body size measures and risk of VTE in the general population. Findings will be published in peer-reviewed journal and presented at scientific meetings. PROSPERO REGISTRATION NUMBER:CD CRD42017071996.

Project description:BackgroundClinically unsuspected venous thromboembolic events (uVTE) detected during routine imaging pose a management challenge due to limited knowledge about their clinical significance. Unsuspected VTE are often referred as "asymptomatic," "incidental," or "clinically silent/occult" VTE.ObjectiveTo understand the epidemiology, management, and outcomes of uVTE in children.MethodsA systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search criteria included controlled vocabulary and keywords for VTE, incidental findings, and children (ages ≤ 21 years).ResultsAmong 10 875 articles, 51 studies (8354 children with 758 uVTE) were selected. The studies were heterogeneous, I2 96%; P < .0001. Unsuspected VTE were diagnosed in two settings: first, asymptomatic VTE (aVTE) diagnosed through surveillance imaging for VTE (46 studies; n = 5894; aVTE: 715, pooled frequency: 19%, 95% confidence interval [CI]: 13%-24%); second, incidental VTE (iVTE) diagnosed during imaging performed for indications without primary suspicion for VTE (6 studies; n = 2460; iVTE: 43). The majority (94%) of aVTE were associated with central venous lines (CVL). Non-CVL settings included post-spinal surgery, post-splenectomy, trauma, nephrotic syndrome, and newborns. In general, aVTE were reported to have a benign clinical course, were mostly transient, and resolved without intervention and with few immediate or long-term functional complications. Incidental VTE were primarily detected in children with cancer and ranged from tumor-associated thrombi to pulmonary embolism (PE) with insufficient evidence to draw meaningful conclusions about their management.ConclusionClinically uVTE were predominantly diagnosed with CVL and their outcomes were generally favorable implying limited benefit of routine surveillance and thromboprophylaxis. Prospective research is needed to clarify the optimal management of iVTE.

Dataset Information

Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol.

Publications

Epidemiology of venous thromboembolism in people with active tuberculosis: a systematic review and meta-analysis protocol.

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