PO-53 - Prospective evaluation of risk assessment models and biological markers of hypercoagulability for the identification of high VTE risk patients with lung adenocarcinoma. The ROADMAP study

Abstract Aim Multiple tools (NELA, P-POSSUM, ACS-NSQIP) are available to assess mortality risks in patients requiring emergency laparotomy(1–3), but they are time-consuming to perform and have had limited uptake in routine clinical practice in many countries(4). Simpler measures, including psoas muscle:L3 vertebrae (PM:L3) ratio(5,6), may be useful alternates. This measure is quick to perform, requiring no special skills or equipment apart from basic CT viewing software. Method We performed an analysis on all patients in the Hunter Emergency Laparotomy Audit (HELA) database, from January 2016 to December 2017. HELA is a retrospective review of all emergency laparotomy undertaken in a discrete area in NSW, Australia. Patients with an available CT abdomen were included (N = 500/562). A single slice axial CT image at the L3 endplate level was analysed using ImageJ® software to measure the area of L3 and bilateral psoas muscles. This can be done using normal PACS software in routine practice. Results PM:L3 ratios in this cohort have a mean of 1.082 (95%CI 1.042-1.122; range 0.141-3.934). PM:L3 ratio is significantly lower (p < 0.00001) in those patients who did not survive beyond 30 days (mean 0.865 [95% CI 0.746-0.984 ]) and 90 days (mean 0.888 [95%CI 0.768-1.008]) compared to patients that survived these periods (30 day mean 1.106 [95% vs. 1.033-1.179], 90 day mean 1.112 [95% CI 1.070-1.154]) . These associations are similar to those calculated by established risk assessment models. Conclusions PM:L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy.

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Prospective Evaluation of Clinical and Biological Markers To Predict the Outcome of Invasive Pulmonary Aspergillosis in Hematological Patients

Journal of Clinical Microbiology ◽

10.1128/jcm.00750-11 ◽

2011 ◽

Vol 50 (3) ◽

pp. 823-830 ◽

Cited By ~ 52

Author(s):

A. Bergeron ◽

R. Porcher ◽

J. Menotti ◽

J. L. Poirot ◽

K. Chagnon ◽

...

Keyword(s):

Biological Markers ◽

Invasive Pulmonary Aspergillosis ◽

Prospective Evaluation ◽

Pulmonary Aspergillosis ◽

Hematological Patients ◽

And Biological Markers

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Occupational lung diseases: statistical indicators, risk assessment and biological markers

EMERGENCY MEDICINE ◽

10.22141/2224-0586.1.88.2018.124982 ◽

2018 ◽

Vol 0 (1.88) ◽

pp. 142-150 ◽

Cited By ~ 1

Author(s):

S.A. Babanov ◽

D.S. Budash

Keyword(s):

Risk Assessment ◽

Biological Markers ◽

Lung Diseases ◽

Occupational Lung Diseases ◽

And Biological Markers ◽

Statistical Indicators

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Abstract 378: A Systematic Review of Mobility/Immobility in Thromboembolism Risk Assessment Models for Hospitalized Patients

Circulation Research ◽

10.1161/res.121.suppl_1.378 ◽

2017 ◽

Vol 121 (suppl_1) ◽

Author(s):

Fan Ye ◽

Carolyn Stalvey ◽

Matheen Khuddus ◽

David Winchester ◽

Hale Toklu ◽

...

Keyword(s):

Systematic Review ◽

Risk Assessment ◽

Clinical Practice ◽

Venous Thromboembolism ◽

Clinical Studies ◽

Point Of Care ◽

Risk Assessment Models ◽

Increased Risk ◽

Medical Inpatients ◽

Risk Patients

Introduction: Venous thromboembolism (VTE) is a potentially fatal disorder. Prophylaxis is often suboptimal in medical inpatients, attributed to the difficulty in identifying at-risk patients. Simple and validated risk-assessment models (RAMs) are available to assist clinicians in identifying and stratifying patients who have a higher likelihood for developing VTE. Despite the well-documented association of immobility with increased risk of thrombosis, immobility is not consistently defined in clinical studies. Methods: We conducted a systematic review of published RAMs, based on objective criteria, to determine how the term immobility is defined in RAMs. Results: We identified seventeen RAMs with six being externally validated. The concept of immobility is vaguely described in different RAMs, impacting the validity of these models in clinical practice. The widespread variability in defining mobility in RAMs precluded its accurate clinical application further limiting generalization of published RAMs. Conclusion: Externally validated RAMs with clearly defined qualitative or quantitative terms of immobility are needed to assess VTE risk in real-time at the point-of-care.

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Are standardised caries risk assessment models effective?

Evidence-Based Dentistry ◽

10.1038/sj.ebd.6401338 ◽

2018 ◽

Vol 19 (4) ◽

pp. 102-103 ◽

Cited By ~ 1

Author(s):

Soraya C Leal

Keyword(s):

Risk Assessment ◽

Caries Risk ◽

Caries Risk Assessment ◽

Risk Assessment Models

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VTE risk assessment in cancer

Onkologische Welt ◽

10.1055/s-0038-1624994 ◽

2016 ◽

Vol 07 (01) ◽

pp. 20-25

Author(s):

I. Pabinger ◽

C. Ay

Keyword(s):

Risk Assessment ◽

Cancer Patients ◽

Medical Oncology ◽

Clinical Importance ◽

Cancer Surgery ◽

Ambulatory Setting ◽

Oncology Patients ◽

Related Factors ◽

Risk Assessment Models ◽

Increased Risk

SummaryVenous thromboembolism (VTE) in patients with cancer is associated with an increased morbidity and mortality, and its prevention is of major clinical importance. However, the VTE rates in the cancer population vary between 0.5% - 20%, depending on cancer-, treatment- and patient-related factors. The most important contributors to VTE risk are the tumor entity, stage and certain anticancer treatments. Cancer surgery represents a strong risk factor for VTE, and medical oncology patients are at increased risk of developing VTE, especially when receiving chemotherapy or immunomodulatory drugs. Also biomarkers have been investigated for their usefulness to predict risk of VTE (e.g. elevated leukocyte and platelet counts, soluble P-selectin, D-dimer, etc.). In order to identify cancer patients at high risk of VTE and to improve risk stratification, risk assessment models have been developed, which contain both clinical parameters and biomarkers. While primary thromboprophylaxis with lowmolecular- weight-heparin (LMWH) is recommended postoperatively for a period of up to 4 weeks after major cancer surgery, the evidence is less clear for medical oncology patients. Thromboprophylaxis in hospitalized medical oncology patients is advocated, and is based on results of randomized controlled trials which evaluated the efficacy and safety of LMWH for prevention of VTE in hospitalized medically ill patients. In recent trials the benefit of primary thromboprophylaxis in cancer patients receiving chemotherapy in the ambulatory setting has been investigated. However, at the present stage primary thromboprophylaxis for prevention of VTE in these patients is still a matter of debate and cannot be recommended for all cancer outpatients.

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Risk assessment models with functionally different influences on natural and technical systems

Technology of technosphere safety ◽

10.25257/tts.2020.3.89.8-19 ◽

2020 ◽

Vol 89 ◽

pp. 8-19

Author(s):

V. A. Minaev ◽

◽

N. G. Topolsky ◽

A. O. Faddeev ◽

R. O. Stepanov ◽

...

Keyword(s):

Risk Assessment ◽

Differential Equations ◽

Research Area ◽

Practical Implementation ◽

Model Assessment ◽

Mathematical Functions ◽

Effective Response ◽

Risk Assessment Models ◽

Technical Systems ◽

Material Values

Introduction. The complex combination of natural and technogenic factors that lead to dangerous threats to the health and life of the population, as well as to material values, creates a need to develop special mathematical models for risk assessment in the relevant territories. Herewith it is important to take into account the significant differences between these factors. The new areas of research are models that describe natural and technogenic risks using differential equations that reflect different types of functions. The article presents the development of this research area. Goals and objectives. The goal of the article is to create a model for risk assessment in natural and technical systems (PTS), based on taking into account the influences of different natural and technogenic factors on them. Objectives include justification, construction and practical implementation of the mathematical model of risk assessment in the form of differential equations system. Methods include interpretation of the considered influences on PTS in terms of risks and assessment of the dynamic interaction of natural and technogenic factors in the form of inhomogeneous differential equations. Results and discussion. Solutions for models of assessing complex natural and technogenic risks in relation to two cases that differ in NTS are found: functionally different external natural and technogenic influences on PTS, which are understood as their type, in which the effects of both natural and technogenic factors are described by different mathematical functions. Conclusions. The first model considers parabolic (reflecting threats whose intensity gradually decreases with distance from the epicenter) and linear types of influences (reflecting sudden threats). The second model considers parabolic and hyperbolic (reflecting threats, the intensity of which decreases sharply over time) types of influences. It is concluded that it is necessary to create a special computer album of complex influences on the PTS in order to prevent "replay" of various situations and develop the most effective response to emerging dangers from the EMERCOM units and other structures. Key words: model, assessment, natural and technogenic risks, functionally different influences, counteraction, EMERCOM units.

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Association between ultrasound findings, tumor type, grade, and biological markers in patients with breast cancer

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0048-1 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Yasmine Mohamed Elsaeid ◽

Dina Elmetwally ◽

Salwa Mohamed Eteba

Keyword(s):

Breast Cancer ◽

Biological Markers ◽

Tumor Grade ◽

The State ◽

Tumor Type ◽

Breast Cancers ◽

Duct Carcinoma ◽

Ultrasound Findings ◽

Her 2 ◽

And Biological Markers

Abstract Background This prospective study included 65 female patients with primary breast cancer. Ultrasound was performed for all patients. Ultrasound findings were analyzed according to the ACR BI-RADS lexicon 5th edition and correlated with tumor type, grade, and biological markers (ER, PR, HER-2/neu, and Ki67). The purpose of this study is to assess the association between ultrasound findings, tumor type, grade, and the state of biological markers in patients with breast cancer. Results Irregular shape and speculated margins are more frequently associated with invasive duct carcinoma than DCIS (p value < 0.001). There were no association between the ultrasound findings (shape, margin, orientation, echopattern, and posterior features) and the tumor grade (p value 1.0, 0, 0.544, 1.0, and 1.0), respectively. Irregular shape is more frequently seen in ER and PR positive breast cancers (p value = 0.036 and 0.026, respectively). Non-circumscribed margins were frequently seen in PR positive breast cancers (p value = 0.068). No statistically significant difference between US descriptors and HER-2/neu-positive cases. Conclusion Irregularly shaped tumors with speculated margins are frequently seen in invasive duct carcinoma and also more frequently seen in ER-, PR-, and Ki67-positive cases. No relation between ultrasound descriptors and the tumor grade of invasive duct carcinoma. Also, there were no relation between ultrasound descriptors and the state of HER-2/neu.

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