• Something wrong with this record ?

A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs

J. Trujillo-Santos, F. Lozano, MA. Lorente, D. Adarraga, J. Hirmerova, J. Del Toro, L. Mazzolai, G. Barillari, M. Barrón, M. Monreal, . ,

. 2015 ; 128 (1) : 90.e9-15.

Language English Country United States

Document type Journal Article, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc15014061

BACKGROUND: No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS: As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS: Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc15014061
003      
CZ-PrNML
005      
20150429111324.0
007      
ta
008      
150420s2015 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.amjmed.2014.08.023 $2 doi
035    __
$a (PubMed)25242230
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Trujillo-Santos, Javier $u Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain.
245    12
$a A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs / $c J. Trujillo-Santos, F. Lozano, MA. Lorente, D. Adarraga, J. Hirmerova, J. Del Toro, L. Mazzolai, G. Barillari, M. Barrón, M. Monreal, . ,
520    9_
$a BACKGROUND: No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS: As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS: Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a ambulantní péče $x normy $x statistika a číselné údaje $7 D000553
650    _2
$a antikoagulancia $x terapeutické užití $7 D000925
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a dolní končetina $x krevní zásobení $7 D035002
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a pacienti ambulantní $x statistika a číselné údaje $7 D010045
650    _2
$a prognóza $7 D011379
650    _2
$a hodnocení rizik $x metody $7 D018570
650    _2
$a žilní trombóza $x komplikace $x diagnóza $x terapie $7 D020246
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Lozano, Francisco $u Department of Angiology and Vascular Surgery, Complejo Asistencial de Salamanca, Salamanca, Spain.
700    1_
$a Lorente, Manuel Alejandro $u Department of Internal Medicine, Hospital de la Agencia Valenciana de Salud Vega Baja, Alicante, Spain.
700    1_
$a Adarraga, Dolores $u Department of Internal Medicine, Hospital de Montilla, Córdoba, Spain. $7 gn_A_00001666
700    1_
$a Hirmerova, Jana $u Department of Internal Medicine, University Hospital Plzen, Plzen, Czech Republic.
700    1_
$a Del Toro, Jorge $u Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
700    1_
$a Mazzolai, Lucia $u Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
700    1_
$a Barillari, Giovanni $u Department of Internal Medicine, Ospedale S. Maria della Misericordia, Udine, Italy.
700    1_
$a Barrón, Manuel $u Department of Pneumonology, Hospital San Pedro, Logroño, La Rioja, Spain.
700    1_
$a Monreal, Manuel $u Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Electronic address: mmonreal.germanstrias@gencat.cat.
700    1_
$a ,
773    0_
$w MED00009113 $t The American journal of medicine $x 1555-7162 $g Roč. 128, č. 1 (2015), s. 90.e9-15
856    41
$u https://pubmed.ncbi.nlm.nih.gov/25242230 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20150420 $b ABA008
991    __
$a 20150429111628 $b ABA008
999    __
$a ok $b bmc $g 1071642 $s 896939
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2015 $b 128 $c 1 $d 90.e9-15 $i 1555-7162 $m The American journal of medicine $n Am J Med $x MED00009113
LZP    __
$a Pubmed-20150420

Find record

Citation metrics

Archiving options