Hasan Kakli's scientific contributions

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    • Because VTE is the most common thrombotic event, much research has focused on the effect of thromboprophylaxis on VTE. However, the effect of prophylaxis on other thrombotic events such as MI and stroke also should be considered, because the impact of these events together are as great as VTE alone and are highly related to mortality and morbidity [6,8]. In agreement with our findings, Kakkar et al. [42] reported no difference between short and extended duration of thromboprophylaxis regarding the risk of MI and stroke.
    [Show abstract] [Hide abstract] ABSTRACT: Clinical trials have provided evidence about efficacy and safety of extended thromboprophylaxis among total hip replacement (THR) patients. There is a lack of evidence on effectiveness and safety of extended treatment in unselected patients from routine clinical practice. We examined the effectiveness and safety of short (1-6 days) and standard (7-27 days) compared with extended (≥28days) thromboprophylaxis using population-based design. Among all primary THR procedures performed in Denmark from 2010 through 2012 (n=16,865), we calculated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for risk of symptomatic venous thromboembolism (VTE) and major bleeding, in addition to net clinical benefit, defined as the number of VTE avoided minus the number of excess bleeding events occurring among patients prescribed short-term and standard versus extended treatment. The 90-day risks of VTE were 1.1% (short), 1.4% (standard), and 1.0% (extended), yielding aHRs of 0.83 (95% CI: 0.52-1.31) and 0.82 (95% CI: 0.50-1.33) for short and standard versus extended treatment. The risk of major bleeding was 1.1% (short), 1.0% (standard), and 0.7% (extended), resulting in aHRs of 1.64 (95% CI: 0.83-3.21) and 1.24 (95%CI: 0.61-2.51) for short and standard versus extended thromboprophylaxis. Direct comparison between benefits and harms using net clinical benefit analyses did not favor any of the three treatment durations. The same results were found for VTE or death. In a real-word observational cohort of unselected THR patients, we observed no difference in the risks of symptomatic VTE, VTE/ death or bleeding with respect to thromboprophylaxis duration. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Full-text · Article · Dec 2014