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Foppen M, Lodewijkx R, Bandral HV, Yah K, Slot KM, Vandertop W, Verbaan D. Factors associated with success of conservative therapy in chronic subdural hematoma: a single-center retrospective analysis. J Neurol 2024:10.1007/s00415-024-12307-2. [PMID: 38554149 DOI: 10.1007/s00415-024-12307-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Conservative therapy is a viable option for patients with chronic subdural hematoma (cSDH) who express no, or only mild symptoms. It is not clear which factors are associated with success of conservative therapy. This study aims to determine conservative therapy's success rate and to identify features possibly associated with success. METHODS A monocenter retrospective cohort study, including cSDH patients treated conservatively (wait-and-watch) from 2012 to 2022, was performed. The primary outcome was success of conservative therapy, defined as 'no crossover to surgery' during the follow-up period. Secondary outcomes were (1) factors associated with success, analyzed with univariate and multivariable logistic regression analyses, (2) 30-day mortality (3) time to crossover and (4) reasons for crossover. RESULTS We included 159 patients. Conservative therapy was successful in 96 (60%) patients. Hematoma volume (OR 0.79, 95% CI 0.69-0.92) and hypodense hematoma type (OR 3.57, 95% 1.38-9.23) were associated with success. Thirty-day mortality rate was 5% and the median duration between diagnosis and surgery was 19 days (IQR 8-39). Clinical deterioration was the most frequent reason for crossover (in 61/63 patients, 97%) and was accompanied by radiological hematoma progression in 42 patients (67%). CONCLUSION In this selected group of patients, conservative therapy was successful in 60%. Smaller hematoma volume and hypodense hematoma type were associated with success. As time until crossover was approximately three weeks, deploying conservative therapy as primary treatment seems safe and could be rewarding as surgical complications can be avoided. Improvement in patient selection in future cohorts remains warranted.
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Affiliation(s)
- Merijn Foppen
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands.
| | - Roger Lodewijkx
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
| | - Harssh Verdan Bandral
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
| | - Kevin Yah
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
| | - K Mariam Slot
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
| | - William Vandertop
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
| | - Dagmar Verbaan
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Room H2-241, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, The Netherlands
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Foppen M, Bandral HV, Slot KAM, Vandertop WP, Verbaan D. Success of conservative therapy for chronic subdural hematoma patients: a systematic review. Front Neurol 2023; 14:1249332. [PMID: 37780712 PMCID: PMC10540204 DOI: 10.3389/fneur.2023.1249332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Background Conservative therapy for chronic subdural hematoma (cSDH) is an option for patients who express no, or only mild symptoms, thereby preventing surgery in some. Because it is not clear for whom conservative therapy is successful, we aimed to estimate the success rate of conservative therapy and to identify which factors might influence success. Methods We systematically searched MEDLINE and EMBASE databases to identify all available publications reporting outcome of conservative therapy for cSDH patients. Studies containing >10 patients were included. The primary outcome was the success rate of conservative therapy, defined as "no crossover to surgery" during follow-up. In addition, factors possibly associated with success of conservative therapy were explored. Bias assessment was performed with the Newcastle Ottowa Scale and the Cochrane risk-of-bias tool. We calculated pooled incidence and mean estimates, along with their 95% confidence intervals (CIs), using OpenMeta[Analyst] software. Results The search yielded 1,570 articles, of which 11 were included in this study, describing 1,019 conservatively treated patients. The pooled success rate of conservative therapy was 66% (95% CI: 50-82%). One study (n = 98) reported smaller hematoma volume to be associated with success, whilst another study (n = 53) reported low hematoma density and absence of paresis at diagnosis to be associated with success. Conclusion Conservative therapy is reported to be successful in the majority of cSDH patients who have either no, or only mild symptoms. Hematoma volume, low hematoma density and absence of paresis could be factors associated with success. However, further research is warranted in order to establish factors consistently associated with a successful conservative therapy. Other No funding was acquired for this study. The study was not registered nor was a study protocol prepared.
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Affiliation(s)
- M. Foppen
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, Netherlands
| | - Harssh Verdan Bandral
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, Netherlands
| | - Kari-Anne Mariam Slot
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, Netherlands
| | - W. P. Vandertop
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, Netherlands
| | - D. Verbaan
- Department of Neurosurgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurovascular Disorders, Amsterdam, Netherlands
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Lodewijkx R, Foppen M, Slot KAM, Vandertop WP, Verbaan D. Recurrent Chronic Subdural Hematoma After Burr-Hole Surgery and Postoperative Drainage: A Systematic Review and Meta-Analysis. Oper Neurosurg (Hagerstown) 2023; 25:216-241. [PMID: 37387582 PMCID: PMC10389757 DOI: 10.1227/ons.0000000000000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/18/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Reported recurrence rates of chronic subdural hematoma treated by burr-hole surgery with postoperative drainage vary considerably in the literature. We performed a systematic review and meta-analysis to define the recurrence rate of burr-hole surgery with postoperative drainage. METHODS PubMed and EMBASE were searched, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. We used the Newcastle-Ottawa scale and Cochrane risk-of-bias tool for quality assessment of included studies and the random-effects model to calculate pooled incidence rates in R with the metaprop function if appropriate. RESULTS The search yielded 2969 references; 709 were screened full text, and 189 met the inclusion criteria. In 174 studies (34 393 patients), the number of recurrences was reported as per patient and 15 studies (3078 hematomas) reported the number of recurrences per hematoma, for a pooled incidence of 11.2% (95% CI: 10.3-12.1; I 2 = 87.7%) and 11.0% (95% CI: 8.6-13.4; I 2 = 78.0%), respectively. The pooled incidence of 48 studies (15 298 patients) with the highest quality was 12.8% (95% CI 11.4-14.2; I 2 = 86.1%). Treatment-related mortality (56 patients) has a pooled incidence of 0.7% (95% CI 0.0-1.4; I 2 = 0.0%). CONCLUSION The recurrence rate of chronic subdural hematoma treated by burr-hole surgery and postoperative drainage is 12.8%.
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Affiliation(s)
- Roger Lodewijkx
- Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Merijn Foppen
- Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Kari-Anne Mariam Slot
- Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - William Peter Vandertop
- Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Dagmar Verbaan
- Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
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Holl DC, Mikolic A, Blaauw J, Lodewijkx R, Foppen M, Jellema K, van der Gaag NA, den Hertog HM, Jacobs B, van der Naalt J, Verbaan D, Kho KH, Dirven CMF, Dammers R, Lingsma HF, van Klaveren D. External validation of prognostic models predicting outcome after chronic subdural hematoma. Acta Neurochir (Wien) 2022; 164:2719-2730. [PMID: 35501576 PMCID: PMC9519711 DOI: 10.1007/s00701-022-05216-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/07/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Several prognostic models for outcomes after chronic subdural hematoma (CSDH) treatment have been published in recent years. However, these models are not sufficiently validated for use in daily clinical practice. We aimed to assess the performance of existing prediction models for outcomes in patients diagnosed with CSDH. METHODS We systematically searched relevant literature databases up to February 2021 to identify prognostic models for outcome prediction in patients diagnosed with CSDH. For the external validation of prognostic models, we used a retrospective database, containing data of 2384 patients from three Dutch regions. Prognostic models were included if they predicted either mortality, hematoma recurrence, functional outcome, or quality of life. Models were excluded when predictors were absent in our database or available for < 150 patients in our database. We assessed calibration, and discrimination (quantified by the concordance index C) of the included prognostic models in our retrospective database. RESULTS We identified 1680 original publications of which 1656 were excluded based on title or abstract, mostly because they did not concern CSDH or did not define a prognostic model. Out of 18 identified models, three could be externally validated in our retrospective database: a model for 30-day mortality in 1656 patients, a model for 2 months, and another for 3-month hematoma recurrence both in 1733 patients. The models overestimated the proportion of patients with these outcomes by 11% (15% predicted vs. 4% observed), 1% (10% vs. 9%), and 2% (11% vs. 9%), respectively. Their discriminative ability was poor to modest (C of 0.70 [0.63-0.77]; 0.46 [0.35-0.56]; 0.59 [0.51-0.66], respectively). CONCLUSIONS None of the examined models showed good predictive performance for outcomes after CSDH treatment in our dataset. This study confirms the difficulty in predicting outcomes after CSDH and emphasizes the heterogeneity of CSDH patients. The importance of developing high-quality models by using unified predictors and relevant outcome measures and appropriate modeling strategies is warranted.
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Affiliation(s)
- Dana C. Holl
- grid.5645.2000000040459992XDepartment of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands ,grid.414842.f0000 0004 0395 6796Department of Neurology, Haaglanden Medical Centre, Hague, The Netherlands
| | - Ana Mikolic
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jurre Blaauw
- grid.4494.d0000 0000 9558 4598Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roger Lodewijkx
- Department of Neurosurgery, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Merijn Foppen
- Department of Neurosurgery, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Korné Jellema
- grid.414842.f0000 0004 0395 6796Department of Neurology, Haaglanden Medical Centre, Hague, The Netherlands
| | - Niels A. van der Gaag
- grid.10419.3d0000000089452978University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Centre, Haga Teaching Hospital, Leiden, The Netherlands
| | - Heleen M. den Hertog
- grid.452600.50000 0001 0547 5927Department of Neurology, Isala Hospital Zwolle, Zwolle, The Netherlands
| | - Bram Jacobs
- grid.4494.d0000 0000 9558 4598Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joukje van der Naalt
- grid.4494.d0000 0000 9558 4598Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dagmar Verbaan
- Department of Neurosurgery, Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - K. H. Kho
- Department of Neurosurgery, NeurocenterMedisch Spectrum Twente, Enschede, The Netherlands ,grid.6214.10000 0004 0399 8953Clinical Neurophysiology Group, University of Twente, Enschede, The Netherlands
| | - C. M. F. Dirven
- grid.5645.2000000040459992XDepartment of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Ruben Dammers
- grid.5645.2000000040459992XDepartment of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Hester F. Lingsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David van Klaveren
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 8029-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 1-- -] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 and 1880=1880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 1-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MCA, Bouman CCS, Beenen LFM, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost 2020; 18:1995-2002. [PMID: 32369666 PMCID: PMC7497052 DOI: 10.1111/jth.14888] [Citation(s) in RCA: 1037] [Impact Index Per Article: 259.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications. OBJECTIVES To investigate the incidence of objectively confirmed venous thromboembolism (VTE) in hospitalized patients with COVID-19. METHODS Single-center cohort study of 198 hospitalized patients with COVID-19. RESULTS Seventy-five patients (38%) were admitted to the intensive care unit (ICU). At time of data collection, 16 (8%) were still hospitalized and 19% had died. During a median follow-up of 7 days (IQR, 3-13), 39 patients (20%) were diagnosed with VTE of whom 25 (13%) had symptomatic VTE, despite routine thrombosis prophylaxis. The cumulative incidences of VTE at 7, 14 and 21 days were 16% (95% CI, 10-22), 33% (95% CI, 23-43) and 42% (95% CI 30-54) respectively. For symptomatic VTE, these were 10% (95% CI, 5.8-16), 21% (95% CI, 14-30) and 25% (95% CI 16-36). VTE appeared to be associated with death (adjusted HR, 2.4; 95% CI, 1.02-5.5). The cumulative incidence of VTE was higher in the ICU (26% (95% CI, 17-37), 47% (95% CI, 34-58), and 59% (95% CI, 42-72) at 7, 14 and 21 days) than on the wards (any VTE and symptomatic VTE 5.8% (95% CI, 1.4-15), 9.2% (95% CI, 2.6-21), and 9.2% (2.6-21) at 7, 14, and 21 days). CONCLUSIONS The observed risk for VTE in COVID-19 is high, particularly in ICU patients, which should lead to a high level of clinical suspicion and low threshold for diagnostic imaging for DVT or PE. Future research should focus on optimal diagnostic and prophylactic strategies to prevent VTE and potentially improve survival.
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Affiliation(s)
- Saskia Middeldorp
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Thijs F van Haaps
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Merijn Foppen
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alexander P Vlaar
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marcella C A Müller
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Catherine C S Bouman
- Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ludo F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruud S Kootte
- Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jarom Heijmans
- Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Loek P Smits
- Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter I Bonta
- Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nick van Es
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 8029-- awyx] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 8029-- #] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MC, Bouman CC, Beenen LF, Kootte RS, Heijmans J, Smits LP, Bonta PI, van Es N. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost 2020. [DOI: 10.1111/jth.14888 order by 1-- gadu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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