17
|
Roshanov PS, Eikelboom JW, Crowther M, Tandon V, Borges FK, Kearon C, Lamy A, Whitlock R, Biccard BM, Szczeklik W, Guyatt GH, Panju M, Spence J, Garg AX, McGillion M, VanHelder T, Kavsak PA, de Beer J, Winemaker M, Sessler DI, Le Manach Y, Sheth T, Pinthus JH, Thabane L, Simunovic MRI, Mizera R, Ribas S, Devereaux PJ. Bleeding impacting mortality after noncardiac surgery: a protocol to establish diagnostic criteria, estimate prognostic importance, and develop and validate a prediction guide in an international prospective cohort study. CMAJ Open 2017; 5:E594-E603. [PMID: 28943515 PMCID: PMC5963363 DOI: 10.9778/cmajo.20160106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Various definitions of bleeding have been used in perioperative studies without systematic assessment of the diagnostic criteria for their independent association with outcomes important to patients. Our proposed definition of bleeding impacting mortality after noncardiac surgery (BIMS) is bleeding that is independently associated with death during or within 30 days after noncardiac surgery. We describe our analysis plan to sequentially 1) establish the diagnostic criteria for BIMS, 2) estimate the independent contribution of BIMS to 30-day mortality and 3) develop and internally validate a clinical prediction guide to estimate patient-specific risk of BIMS. METHODS In the Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) study, we prospectively collected bleeding data for 16 079 patients aged 45 years or more who had noncardiac inpatient surgery between 2007 and 2011 at 12 centres in 8 countries across 5 continents. We will include bleeding features independently associated with 30-day mortality in the diagnostic criteria for BIMS. Candidate features will include the need for reoperation due to bleeding, the number of units of erythrocytes transfused, the lowest postoperative hemoglobin concentration, and the absolute and relative decrements in hemoglobin concentration from the preoperative value. We will then estimate the incidence of BIMS and its independent association with 30-day mortality. Last, we will construct and internally validate a clinical prediction guide for BIMS. INTERPRETATION This study will address an important gap in our knowledge about perioperative bleeding, with implications for the 200 million patients who undergo noncardiac surgery globally every year. Trial registration: ClinicalTrials.gov, no NCT00512109.
Collapse
Affiliation(s)
- Pavel S Roshanov
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - John W Eikelboom
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Mark Crowther
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Vikas Tandon
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Flavia K Borges
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Clive Kearon
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Andre Lamy
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Richard Whitlock
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Bruce M Biccard
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Wojciech Szczeklik
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Gordon H Guyatt
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Mohamed Panju
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Jessica Spence
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Amit X Garg
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Michael McGillion
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Tomas VanHelder
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Peter A Kavsak
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Justin de Beer
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Mitchell Winemaker
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Daniel I Sessler
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Yannick Le Manach
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Tej Sheth
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Jehonathan H Pinthus
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Lehana Thabane
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Marko R I Simunovic
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Ryszard Mizera
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - Sebastian Ribas
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| | - P J Devereaux
- Affiliations: Lilibeth Caberto Kidney Clinical Research Unit (Roshanov, Garg), London Health Sciences Centre, London, Ont.; Department of Medicine (Eikelboom, Tandon, Borges, Kearon, Panju, Sheth, Mizera, Ribas, Devereaux), Department of Surgery (Lamy, Whitlock, de Beer, Winemaker, Pinthus, Simunovic), Department of Health Research Methods, Evidence, and Impact (Lamy, Guyatt, Le Manach, Thabane, Simunovic, Devereaux), Department of Pathology and Molecular Medicine (Crowther, Kavsak), Department of Anesthesia (Spence, VanHelder, Le Manach), Thrombosis and Atherosclerosis Research Institute (Kearon) and School of Nursing (McGillion), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Population Health Research Institute (Eikelboom, Borges, Lamy, Whitlock, Spence, McGillion, Le Manach, Devereaux), Hamilton, Ont.; Department of Anaesthesia and Perioperative Medicine (Biccard), Groote Schuur Hospital, Observatory, South Africa, and University of Cape Town, South Africa; Department of Intensive Care and Perioperative Medicine (Szczeklik), Jagiellonian University Medical College, Krakow, Poland; Institute for Clinical Evaluative Sciences at Western (Garg), London, Ont.; Faculty of Health and Life Sciences (McGillion), Coventry University, Coventry, United Kingdom; Department of Outcomes Research (Sessler), Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.; Biostatistics Unit (Thabane), St. Joseph's Healthcare, Hamilton, Ont
| |
Collapse
|