Incidence and risk factors of venous thromboembolism in patients with amyotrophic lateral sclerosis: a systematic review and meta-analysis

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Published Oct 8, 2024
https://doi.org/10.62438/tunismed.v102i10.5154
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Vol. 102 No. 10 (2024): Tunis Med oct 2024

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Abdullah Ashraf Hamad
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA . Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt
Ibraheem M Alkhawaldeh
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA. Faculty of Medicine, Mutah University, Al-Karak, Jordan.
Abdallah Abbas
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA. Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Ahmed Elaraby
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA. Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Mostafa Meshref
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA. Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Aims: This systematic review and meta-analysis aimed to determine the annual incidence rate of venous thromboembolism (VTE) and identify risk factors of VTE in amyotrophic lateral sclerosis (ALS) patients.


Methods: A comprehensive search of three databases was conducted up to April 8, 2024, to identify longitudinal studies reporting VTE incidence in ALS patients. The included studies were either prospective or retrospective, following up with ALS patients. Quality assessment was performed using the NIH tool for observational cohort studies. Meta-analysis was conducted using Open Meta Analyst, employing a random-effect model. Subgroup, Meta-regression, and sensitivity analyses were also carried out.


Results: Our analysis included eight studies comprising a total of 26,758 ALS patients that met the inclusion criteria. The pooled annual incidence of VTE across all studies was found to be 22 cases per 1,000 person-year (95% CI = 18 to 27). Subgroup analysis revealed that the annual incidence of VTE in males was 19 cases per 1,000 person-year (95% CI = 15 to 22), while in females, it was 20 cases per 1,000 person-year (95% CI = 16 to 25). Leave-one-out analysis demonstrated that the incidence ranged from 21 to 28 cases per 1,000 person-year when excluding each study individually. Meta-regression analysis did not find a significant association between age and the risk of VTE (P = 0.079). Based on the included studies, risk factors of VTE in ALS patients included a history of VTE, non-invasive ventilation, immobility, and decreased functional status.


Conclusion: Patients with ALS face a higher risk of developing VTE compared to individuals of the same age. These findings underscore the importance of implementing preventive measures and closely monitoring VTE in ALS patients.


 


 

Keywords:

Sclérose latérale amyotrophique, Maladie des motoneurones, Maladies neurodégénératives, Embolie pulmonaire, Thromboembolie veineuse

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References

  1. Hardiman O, Al-Chalabi A, Chio A, Corr EM, Logroscino G, Robberecht W, et al. Amyotrophic lateral sclerosis. Nat Rev Dis Prim 2017;3:17071. https://doi.org/10.1038/nrdp.2017.71.
  2. Brown RH, Al-Chalabi A. Amyotrophic Lateral Sclerosis. N Engl J Med 2017;377:162–72. https://doi.org/10.1056/NEJMra1603471.
  3. Sanjak M, Langford V, Holsten S, Rozario N, Patterson CGM, Bravver E, et al. Six-Minute Walk Test as a Measure of Walking Capacity in Ambulatory Individuals With Amyotrophic Lateral Sclerosis. Arch Phys Med Rehabil 2017;98:2301–7. https://doi.org/10.1016/j.apmr.2017.04.004.
  4. Corcia P, Pradat P, Salachas F, Bruneteau G, le Forestier N, Seilhean D, et al. Causes of death in a post‐mortem series of ALS patients. Amyotroph Lateral Scler 2008;9:59–62. https://doi.org/10.1080/17482960701656940.
  5. Gladman M, DeHaan M, Pinto H, Geerts W, Zinman L. Venous thromboembolism in amyotrophic lateral sclerosis. Neurology 2014;82:1674–7. https://doi.org/10.1212/WNL.0000000000000405.
  6. Barnabe A, Genestet S, Gut-Gobert C, Rivalain C, Noury J-B, Goret M, et al. Venous thromboembolism and amyotrophic lateral sclerosis: the Venous Thrombo-Embolism and Sclerosis Lateral Amyotrophic study. Res Pract Thromb Haemost 2024;8:102287. https://doi.org/10.1016/j.rpth.2023.102287.
  7. Caballero-Eraso C, Lopez-Ramirez C, Marin-Romero S, Carrera-Cueva C, Asensio-Cruz MI, Barrot-Cortes E, et al. Venous thromboembolism in amyotrophic lateral sclerosis. A prospective quasi-experimental study. Thromb Res 2022;211:81–4. https://doi.org/10.1016/j.thromres.2022.01.002.
  8. Lutsey PL, Zakai NA. Epidemiology and prevention of venous thromboembolism. Nat Rev Cardiol 2023;20:248–62. https://doi.org/10.1038/s41569-022-00787-6.
  9. Gil J, Funalot B, Verschueren A, Danel‐Brunaud V, Camu W, Vandenberghe N, et al. Causes of death amongst French patients with amyotrophic lateral sclerosis: a prospective study. Eur J Neurol 2008;15:1245–51. https://doi.org/10.1111/j.1468-1331.2008.02307.x.
  10. Page MJ, Mckenzie JE, Bossuyt PM, Boutron I, Hoffmann C, Mulrow CD, et al. The PRISMA 2020 statement : an updated guideline for reporting systematic reviews Systematic reviews and Meta-Analyses 2021. https://doi.org/10.1136/bmj.n71.
  11. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev 2016;5:210. https://doi.org/10.1186/s13643-016-0384-4.
  12. Study Quality Assessment Tools | NHLBI, NIH, (n.d.). Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. n.d.
  13. Wallace BC, Dahabreh IJ, Trikalinos TA, Lau J, Trow P, Schmid CH. Closing the Gap between Methodologists and End-Users: R as a Computational Back-End. J Stat Softw 2012;49. https://doi.org/10.18637/jss.v049.i05.
  14. Viechtbauer W. Conducting Meta-Analyses in R with the metafor Package. J Stat Softw 2010;36. https://doi.org/10.18637/jss.v036.i03.
  15. Elman LB, Siderowf A, Houseman G, Kelley M, McCluskey LF. Venous thrombosis in an ALS population over four years. Amyotroph Lateral Scler 2005;6:246–9. https://doi.org/10.1080/14660820510043226.
  16. Forrest K, O’Rourke P, McCombe P, Henderson R. Venous thromboembolism in amyotrophic lateral sclerosis: Should we consider routine prophylactic anticoagulation? Amyotroph Lateral Scler Front Degener 2015;16:280–1. https://doi.org/10.3109/21678421.2014.984724.
  17. Goldacre R, Trubshaw M, Morris EJA, Talbot K, Goldacre MJ, Thompson AG, et al. Venous thromboembolism risk in amyotrophic lateral sclerosis: a hospital record-linkage study. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333399. https://doi.org/10.1136/jnnp-2024-333399.
  18. Kupelian V, Viscidi E, Hall S, Li L, Eaton S, Dilley A, et al. Increased Risk of Venous Thromboembolism in Patients With Amyotrophic Lateral Sclerosis. Neurol Clin Pract 2023;13. https://doi.org/10.1212/CPJ.0000000000200110.
  19. Qureshi MM, Cudkowicz ME, Zhang H, Raynor E. Increased incidence of deep venous thrombosis in ALS. Neurology 2007;68:76–7. https://doi.org/10.1212/01.wnl.0000250444.30622.ee.
  20. Scheres LJJ, van Hylckama Vlieg A, Cannegieter SC. Sex‐specific aspects of venous thromboembolism: What is new and what is next? Res Pract Thromb Haemost 2022;6:e12722. https://doi.org/10.1002/rth2.12722.
  21. Behringer TS, Collins S. Non-invasive Ventilation: A Gimmick or Does It Really Affect Outcomes? Curr Emerg Hosp Med Rep 2015;3:62–5. https://doi.org/10.1007/s40138-015-0071-0.
  22. MacIntyre NR. Physiologic Effects of Noninvasive Ventilation. Respir Care 2019;64:617–28. https://doi.org/10.4187/respcare.06635.
  23. Eck RJ, Hulshof L, Wiersema R, Thio CHL, Hiemstra B, van den Oever NCG, et al. Incidence, prognostic factors, and outcomes of venous thromboembolism in critically ill patients: data from two prospective cohort studies. Crit Care 2021;25:27. https://doi.org/10.1186/s13054-021-03457-0.