AB0809 PADUA PREDICTION SCORE COMBINED WITH SERUM ALBUMIN FOR THE IDENTIFICATION OF VENOUS THROMBOEMBOLISM OF HOSPITALIZED PATIENTS IN THE DEPARTMENT OF RHEUMATOLOGY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1429.1-1429
Author(s):  
Q. Peng ◽  
L. Long ◽  
J. Liu
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Serum Albumin ◽  
Risk Group ◽  
Assessment Model ◽  
Prediction Score ◽  
Risk Assessment Model ◽  
Systemic Autoimmune Diseases ◽  
Independent Risk Factors ◽  
The Difference

Background:Venous thromboembolism (VTE) includes thrombotic disease of venous system, but primarily includes lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE). Population-based epidemiological studies have shown an association between systemic autoimmune diseases and VTE[1]. The Padua prediction score(PPS) is a new 20-point risk assessment model proposed by Professor Barbar et al[2] in 2010. A large number of researches have shown that low serum albumin concentration is associated with an increased risk of VTE [3],but there is a lack of studies on serum albumin in VTE, and there are no reports on PPS in rheumatology inpatients.Objectives:To investigate the status of VTE in patients in the department of rheumatology, and to explore the value of PPS combined with serum albumin in the identification of VTE in this patient population.Methods:Baseline data of inpatients in rheumatology department were collected at Sichuan Provincial People’s Hospital from September 2018 to September 2020. Occurrence of VTE was compared between high and low risk groups. PPSs were analyzed in VTE and non-VTE patients. Multivariate logistic regression was used to analyze the independent risk factors of VTE. The receiver operating characteristic curve was used to evaluate the probablity of value of rheumatic inpatients with VTE assessed by PPS,serum albumin and PPS with serum albumin. P<0.05 indicates that the difference was statistically significant.Results:A total of 2282 patients were included in this study, and 50(2.2%) had symptomatic VTE. Among the symptomatic VTE cases,38(1.6%) had DVT only,8(0.4%) had PE only, and 4(0.2%) were diagnosed with DVT and PE. PPSs in VTE and non-VTE groups were 3.00(2.00~6.00) and2.00(1.00~2.00) respectively (P< 0.05). One hundred and eighty-eight cases was divided into high-risk group of VTE (PPS≥4), while 2094 cases (PPS<4) were in the low-risk group. Logistic regression analysis showed that known thrombophilic condition, history of VTE, reduced mobility, and D-dimer were independent risk factors of VTE in rheumatology patients, the odd ration(OR) values were 161.90, 26.08, 8.73,and1.04. Serum albumin was the independent protection factor [OR= 0.92(95%CI:0.87~0.98)]. The AUC of PPS model, serum albumin model and the combined predictive model were 0.77, 0.75, 0.84, respectively. The difference between the combined prediction model and PPS model was statistically significant (Z=3.813, P<0.05). The optimal sensitivity of PPS and serum albumin models is 60%, 82%, respectively, and the optimal specificity of is 82.5%,58.6%, respectively. The combination model corresponds to a sensitivity of 62% and a specificity of 90.4%.Conclusion:The incidence of symptomatic VTE was relatively higher in hospitalized patients in rheumatology department. Serum albumin was the protective factor. The combination of albumin and PPS can improve the accuracy of screening for VTE in rheumatology in-patients.References:[1]Tamaki H,Khasnis A.Venous thromboembolism in systemic autoimmune diseases: A narrative review with emphasis on primary systemic vasculitides.[J].Vasc Med, 2015, 20: 369-76.[2]Barbar S, Noventa F, Rossetto V,et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score[J]. J Thromb Haemost,2010,8(11):2450–2457.[3]Kunutsor SK,Seidu S,Katechia DT et al. Inverse association between serum albumin and future risk of venous thromboembolism: interrelationship with high sensitivity C-reactive protein.[J].Ann Med, 2018, 50: 240-248.Disclosure of Interests:None declared

scholarly journals Determination of Risk Factors for Venous Thromboembolism by an Adapted Caprini Scoring System in Surgical Patients

2019 ◽  
Vol 9 (3) ◽  
pp. 36 ◽  
Author(s):  
Bui My Hanh ◽  
Le Quang Cuong ◽  
Nguyen Truong Son ◽  
Duong Tuan Duc ◽  
Tran Tien Hung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Scoring System ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Assessment Model ◽  
Surgical Patients ◽  
Risk Scoring

Venous thromboembolism (VTE) is a frequent preventable complication among surgical patients. Precise risk assessment is a necessary step for providing appropriate thromboprophylaxis and reducing mortality as well as morbidity caused by VTE. We carried out this work to define the rate of VTE postoperatively, following a Caprini score, and to determine VTE risk factors through a modified Caprini risk scoring system. This multicenter, observational, cohort study involved 2,790,027 patients who underwent surgery in four Vietnamese hospitals from 01/2017 to 12/2018. All patients who were evaluated before surgery by using a Caprini risk assessment model (RAM) and monitored within 90 days after surgery. The endpoint of the study was ultrasound-confirmed VTE. Our data showed that the 90-day postoperative VTE was found in 3068 patients. Most of VTE (46.97%) cases were found in the highest risk group (Caprini score > 5). A total of 37.19% were observed in the high risk group, while the rest (15.84%) were from low to moderate risk groups. The likelihood of occurring VTE was heightened 2.83 times for patients with a Caprini score of 3–4, 4.83 times for a Caprini score of 5–6, 8.84 times for a score of 7–8, and 11.42 times for a score of >8, comparing to ones with a score of 0 to 2 (all p values < 0.05). Thus, the frequency of postoperative VTE rises substantially, according to the advanced Caprini score. Further categorizing patients among the highest risk group need delivering more appropriate thromboprophylaxis.

scholarly journals Application of the Caprini Risk Assessment Model for the Assessment of Risk Factors for Postoperative Venous Thromboembolism in the Surgery Department of Anosiala University Hospital

2021 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Jean Baptiste Ramampisendrahova ◽  
Andriamanantsialonina Andrianony ◽  
Aina Andrianina Vatosoa Rakotonarivo ◽  
Mamisoa Bodohasina Rasamoelina ◽  
Eric Andriantsoa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Model ◽  
University Hospital ◽  
Risk Category ◽  
Risk Assessment Model ◽  
Moderate Risk ◽  
Risk Patients ◽  
Surgery Department

The purpose of this research is to ascertain the prevalence of postoperative venous thromboembolism in the Department of Surgery at Anosiala University Hospital and to identify risk factors for developing postoperative venous thromboembolism using the Caprini Risk Assessment Model. From December 2017 to October 2019, this was a 22-month prospective cohort research conducted at Anosiala University Hospital. It included all adult patients over the age of 18 who were operated on in an emergency or on a planned basis by the Department of Surgery. This research included 662 participants. Within 30 days after surgery, the risk of venous thromboembolism was 0.3 percent. According to the overall Caprini score, 25.2 percent of patients were classified as having a low risk of venous thromboembolism, 25.2 percent as having a moderate risk, 29.5 percent as having a high risk, and 20.1 percent as having the greatest risk. Patients in the highest risk category (scoring 5) had a substantially increased chance of having venous thromboembolism after surgery (p = 0.0007). Only major open surgery was related with a statistically significant increase in postoperative venous thromboembolism (p = 0.028). Age 75 years, elective arthroplasty, and hip, pelvic, or leg fractures were not linked with postoperative venous thromboembolism statistically significantly (p> 0.05). Our findings indicate that the Caprini risk assessment model might be used successfully to avoid postoperative venous thromboembolism in surgical patients in Madagascar, since patients in the highest risk category had a considerably increased chance of developing postoperative venous thromboembolism.

scholarly journals The HAS-RISC Score for Venous Thromboembolism (VTE) Risk Stratification in Newly Diagnosed Multiple Myeloma Patients Starting Immunomodulatory Drugs (IMID)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 144-144 ◽  
Author(s):  
Ang Li ◽  
Qian V. Wu ◽  
Greg Warnick ◽  
Neil A Zakai ◽  
Edward N. Libby ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Research Funding ◽  
Risk Group ◽  
High Risk Group ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Newly Diagnosed ◽  
Very High

Abstract Introduction: Patients with newly diagnosed multiple myeloma (MM) have high risk of venous thromboembolism (VTE) when starting initial treatment that contains immunomodulatory drugs (IMID) such as lenalidomide or thalidomide. The National Comprehensive Cancer Network (NCCN) guideline recommends primary anticoagulant thromboprophylaxis for the high-risk patients. However, it is challenging to risk-stratify patients without a validated risk model. We have conducted a retrospective cohort study using the SEER-Medicare (Surveillance, Epidemiology, and End Results) database to derive a new VTE risk assessment model. Methods: We selected all patients 66 or older with newly diagnosed MM 2007 to 2013. Patients were included if they had a prescription of IMID within twelve months of diagnosis and complete enrollment for fee-for-service and prescription drug coverage. We ascertained baseline demographics and VTE risk factors from the current NCCN guideline using validated codes. The VTE outcome was defined as either one inpatient or two outpatient claims at least 30 days apart in combination with an anticoagulant prescription within 90 days. All patients were followed from the date of IMID initiation until first VTE occurrence or death and were censored for disenrollment from Medicare, discontinuation of IMID (after a grace period of 90 days), autologous transplantation, or the end of claims data (12/31/2014). Cause specific Cox regression models were used for time to VTE analysis. For variable selection, all risk factors with p-value <0.10 were considered candidates for inclusion in the final multivariable regression model. VTE history, recent surgery, and anticoagulant exposure were forced into the model, regardless of significance testing. Integer points were assigned according to the beta coefficients and subsequent risk groups were created. The model's discrimination was validated internally by the bias-corrected Harrell's c statistic and the 95% confidence interval was estimated from 200 bootstrap samples. Results: We identified 2397 MM patients on IMID that met the study criteria. The median time on IMID treatment was 116 days (IQR 28-279). The mean age of patients was 74, 49% were female, 80% were White, 13% were Black, 6.5% were Asian. Only 13% of patients had concurrent anticoagulant exposure (11% warfarin, 2% LMWH, 1% DOAC) with a median duration of 116 days (IQR 42-315 days). In the multivariable model built from candidate covariates, we identified history of VTE, recent surgery, cytotoxic (non-bortezomib) chemotherapy, higher dose dexamethasone, older age, and Black race, as important risk factors. Asian race and LMWH/DOAC use were associated with lower VTE risk (Table 1). We derived a risk assessment model that stratified patients into 2 prognostic risk groups (Table 1): 25% (n=581) in the very high-risk group (score 2 to 7), 75% (n=1816) in the standard-risk group (score -3 to 1). The incidence of VTE at 3 months and 6 months were 9.5% and 16.3% in the very high-risk group compared to 3.7% and 6.3% in the standard-risk group with a resulting hazard ratio of 2.73 (p<0.001) (Figure 1). The bias-corrected Harrell's c statistic for the product index was 0.63 (0.59-0.68). Conclusions: We have derived a VTE risk assessment model specifically for patients with MM starting IMID therapy. The HAS-RiSC score combines 7 clinical risk factors - History of VTE, Age 80+, Surgery within last 90 days, Race Black, race Asian, Steroid use, and Chemotherapy - into a simplified VTE risk assessment model that identifies a subgroup of patients at very high risk for VTE. External validation of this risk assessment model is currently in progress. Disclosures Garcia: Daiichi Sankyo: Research Funding; Incyte: Research Funding; Janssen: Consultancy, Research Funding; Pfizer: Consultancy; Retham Technologies LLC: Consultancy; Shingoi: Consultancy; Portola: Research Funding; Bristol Meyers Squibb: Consultancy; Boehringer Ingelheim: Consultancy. Lyman:Amgen: Other: Research support; Generex Biotechnology: Membership on an entity's Board of Directors or advisory committees; Halozyme; G1 Therapeutics; Coherus Biosciences: Consultancy.

scholarly journals Evaluating post-operative venous thromboembolism risk in urology patients using a validated risk assessment model

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Winston Paul René Padayachee ◽  
Mohamed Haffejee ◽  
Marietha Nel
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Significant Risk ◽  
Assessment Model ◽  
Risk Category ◽  
Risk Assessment Model ◽  
Surgical Morbidity ◽  
Significant Difference

Abstract Background Venous thromboembolism (VTE) is an important cause of post-surgical morbidity and mortality. This study aimed to apply a validated risk assessment model to evaluate the risk of post-operative VTE in urology patients. Methods This prospective descriptive observational study used the Caprini risk assessment model to evaluate VTE risk in patients planned for elective urology surgery at a tertiary Johannesburg hospital from January to June 2020. Results Two hundred and twenty-six patients with a mean age of 52 years were evaluated for post-operative VTE risk. The population was generally overweight, with a mean BMI of 26.3 kg/m2. The mean Caprini score was 4.42, reflecting a population at high risk for post-operative VTE. There was no statistically significant difference between males and females in this regard. On average, participants had three risk factors for post-operative VTE. Fifteen per cent of all patients were at low risk for VTE, while 40.3% of participants were categorised as moderate risk. The category with the highest percentage of participants (44.7%) was the high-risk category (Caprini score ≥ 5). High-risk patients undergoing oncology surgery comprised 16.8% of the population, and these patients may require extended duration pharmacological thromboprophylaxis to prevent VTE. The most clinically significant risk factors for post-operative VTE included age, obesity, malignancy and HIV infection. Conclusion Venous thromboembolism may be difficult to diagnose, and clinicians may underestimate the risk for it to develop. Risk assessment models, such as the Caprini score, are objective and a practical tool to guide the application of thromboprophylaxis. The application of the Caprini RAM in the elective urological surgery population at Chris Hani Baragwanath Academic Hospital yields similar results to studies performed elsewhere on similar surgical populations. Further research is required to evaluate whether the actual incidence of VTE correlates with the risk assessment in this population. Clinician compliance with the use of RAMs as well as the corresponding recommendations for prophylaxis may need to be evaluated. A validated risk assessment model which accounts for procedure-specific risks in urology may be useful.

Combining the Platelet-to-Albumin Ratio with Serum and Pathologic Variables to Establish a Risk Assessment Model for Lymph Node Metastasis of Gastric Cancer and Evaluation of Its Predictive Value

2019 ◽  
Author(s):  
Chao Huang ◽  
Yongqiang Xia ◽  
Li Xiao ◽  
Zitao Liu ◽  
Jun Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Univariate Analysis ◽  
Lesion Size ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Multivariate Logistic Regression ◽  
Albumin Ratio ◽  
Differentiation Degree ◽  
Independent Risk Factors

Abstract Background The preoperative platelet count and serum tumor markers have been shown to correlate with the lymph node metastasis (LNM) of gastric cancer (GC).The aim of this study was to establish a risk assessment model that incorporated the platelet-to-albumin ratio (PAR) for LNM of GC and to evaluate its clinical significance. Methods The clinical data of 314 patients with GC diagnosed by postoperative pathology were collected in our hospital. According to whether there was LNM in the pathological specimens of the operation, the patients were divided into the group without LNM and the group with LNM. Univariate analysis and multivariate logistic regression were used to analyze the relevant factors affecting LNM of GC and to identify independent risk factors for LNM of GC. The random forest algorithm was used to extract the important risk factors of LNM in GC. A nomogram model of the risk assessment of LNM of GC was constructed by the “rms” package of R software. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy, sensitivity and specificity of the model for predicting LNM of GC. Results Univariate analysis showed that the factors associated with LNM of GC were sex (P=0.015), smoking (P=0.027), lesion size (P=0.000), pathological type (P=0.001), differentiation degree (P=0.000), infiltration depth (P=0.000), PAR (P=0.005), carbohydrate antigen (CA) 19-9 (P=0.017), CA125 (P=0.000) and CA72-4 (P=0.005). Multivariate logistic regression showed that lesion size [odds ratio (OR): 1.322; P = 0.000], differentiation degree (OR: 0.582; P = 0.001), and depth of invasion (OR: 1.734; P = 0.000) were independent risk factors for LNM in GC. The risk assessment model of LNM in GC was established according to the ranking of variables shown by the random forest algorithm. The C statistic of the model evaluation was 0.827, the sensitivity was77.2%, and the specificity was 74.8%. Conclusion Lesion diameter larger than 2.65 cm, poor differentiation and deep infiltration were high-risk factors for LNM in GC. The nomogram model constructed by PAR, lesion size, infiltration depth, CA125, CA19-9, CA72-4, and differentiation degree, can well predict the risk of LNM in GC.

scholarly journals Risk Factors for Venous Thromboembolism in Hospitalized Patients in the Chinese Population

2018 ◽  
Vol 13 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Chunling Wang ◽  
Fuping Cui ◽  
Junqiu Li ◽  
Xiangzhi Yuan ◽  
Jia Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Chinese Population ◽  
Blood Clot ◽  
Hospitalized Patients ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Medical Patients

AbstractVenous thromboembolism (VTE) refers to the formation of a blood clot inside veins and has a high risk of inducing medical accidents. An effective risk assessment model will help screen high risk populations and prevent the occurrence of VTE. In this study, 287 VTE cases were collected and analyzed for risk factors in a Chinese population. The risks of VTE were evaluated using the Caprini and Padua models. Our results indicated that the Caprini model was more effective in evaluating VTE risk among hospitalized patients than the Padua model. As well, the Caprini model was more relevant in VTE risk assessment among surgery patients compared with internal medicine patients, while the Padua model showed no significant differences. In our studies, the most frequent risk factors included obesity, medical patients currently at bed rest, and severe lung disease. Our studies provide clinical support on selecting the suitable risk assessment model of VTE in the Chinese population.

Risk assessment model for venous thromboembolism in hospitalized surgical and non-surgical patients in the 4th Hungarian Antithrombotic Guidelines entitled “Diminution and Treatment of Venous Thromboembolism”

2010 ◽  
Vol 151 (34) ◽  
pp. 1365-1374 ◽  
Author(s):  
Marianna Dávid ◽  
Hajna Losonczy ◽  
Miklós Udvardy ◽  
Zoltán Boda ◽  
György Blaskó ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Assessment Model ◽  
Surgical Patients ◽  
Risk Assessment Model

A kórházban kezelt sebészeti és belgyógyászati betegekben jelentős a vénásthromboembolia-rizikó. Profilaxis nélkül, a műtét típusától függően, a sebészeti beavatkozások kapcsán a betegek 15–60%-ában alakul ki mélyvénás trombózis vagy tüdőembólia, és az utóbbi ma is vezető kórházi halálok. Bár a vénás thromboemboliát leggyakrabban a közelmúltban végzett műtéttel vagy traumával hozzák kapcsolatba, a szimptómás thromboemboliás események 50–70%-a és a fatális tüdőembóliák 70–80%-a nem a sebészeti betegekben alakul ki. Nemzetközi és hazai felmérések alapján a nagy kockázattal rendelkező sebészeti betegek többsége megkapja a szükséges trombózisprofilaxist. Azonban profilaxis nélkül marad a rizikóval rendelkező belgyógyászati betegek jelentős része, a konszenzuson alapuló nemzetközi és hazai irányelvi ajánlások ellenére. A belgyógyászati betegek körében növelni kell a profilaxisban részesülők arányát és el kell érni, hogy trombózisrizikó esetén a betegek megkapják a hatásos megelőzést. A beteg trombóziskockázatának felmérése fontos eszköze a vénás thromboembolia által veszélyeztetett betegek felderítésének, megkönnyíti a döntést a profilaxis elrendeléséről és javítja az irányelvi ajánlások betartását. A trombózisveszély megállapításakor, ha nem ellenjavallt, profilaxist kell alkalmazni. „A thromboemboliák kockázatának csökkentése és kezelése” című, 4. magyar antithromboticus irányelv felhívja a figyelmet a vénástrombózis-rizikó felmérésének szükségességére, és elsőként tartalmazza a kórházban fekvő belgyógyászati és sebészeti betegek kockázati kérdőívét. Ismertetjük a kockázatbecslő kérdőíveket és áttekintjük a kérdőívekben szereplő rizikófaktorokra vonatkozó bizonyítékokon alapuló adatokat.

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