Site evaluation: Peer Review Article

 

Summary of peer review

Aim of the study:

ALS patient has multiple risk factors for VTE: reduce mobility, progressive respiratory failure. This study aims to assess the incidence of VTE in ALS patients and explore another range of risk factors.

 

Exclusion Criteria: anticoagulation use and major surgeries within the past 3 months, active cancer and symptomatic VTE

 

Inclusion Criteria: ALS, age> 18 years, and incapacity to provide consent

 

Sample size: N=50 36 males and 14 females

 

Method: Bilateral venous duplex ultrasonography at enrolment, 6 months and 12 months

 

Result: 1-year incidence of VTE was 11.2% and there is an association between leg weakness and increased risk of VTE

 

Important Finding:

• VTE is more common in patient with ALS
• Patient with leg weakness and reduced mobility has the highest incidence of VTE in 1 year
• Clinicians should have a low threshold of considering VTE in an ALS patient and especially an ALS patient with leg weakness
• The author suggests further studies need to be conducted in order to determine the benefits and risk of primary prophylaxis on a high-risk patient like ALS patient with leg weakness

The drawback of the studies

• A small sample group of 50 participants
• 15 patient dies and 6 patients drop out prior to completion which limits the power of the study
• The follow up was limited to 1 year
• Also, 40% of the cohort had leg onset disease which could have resulted in overestimation on VTE in ALS patient
• More male than female and the sample size was too small to determine to weather the risk of VTE is gender-dependent or not