Validation of a score for predicting fatal bleeding in patients receiving anticoagulation for venous thromboembolism.
Details
Serval ID
serval:BIB_179561E54B8C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Validation of a score for predicting fatal bleeding in patients receiving anticoagulation for venous thromboembolism.
Journal
Thrombosis Research
Working group(s)
RIETE Investigators
Contributor(s)
Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Schellong S., Papadakis M., Tzoran I., Reis A., Bosevski M., Bounameaux H., Malý R., Arcelus JI., Arroyo M., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Bascuñana J., Bedate P., Blanco-Molina A., Bueso T., Casado I., del Molino F., del Toro J., Falgá C., Fernández-Capitán C., Fole D., Gallego P., García-Bragado F., Gavín O., Gómez V., González J., González-Bachs E., Grau E., Guil M., Guijarro R., Gutiérrez J., Hernández L., Hernández-Huerta S., Jara-Palomares L., Jaras MJ., Jiménez D., Lecumberri R., Lobo JL., López-Jiménez L., López-Sáez JB., Lorente MA., Lorenzo A., Luque JM., Madridano O., Maestre A., Marchena PJ., Martín-Villasclaras JJ., Monreal M., Muñoz FJ., Nauffal MD., Nieto JA., Núñez MJ., Ogea JL., Otero R., Paul HE., Pedrajas JM., Peris ML., Quezada CA., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Román P., Rosa V., Ruiz J., Ruiz-Gamietea A., Ruiz-Giménez N., Sahuquillo JC., Samperiz A., Sánchez Muñoz-Torrero JF. , Soler S., Tiberio G., Tolosa C., Trujillo J., Uresandi F., Valdés M., Valero B., Valle R., Vela J., Vidal G., Villalobos A., Villalta J., Malý R., Hirmerova J., Salgado E., Sánchez GT., Bertoletti L., Bura-Riviere A., Farge-Bancel D., Mahe I., Merah A., Quere I., Schellong S., Babalis D., Papadakis M., Tzinieris I., Braester A., Brenner B., Tzoran I., Barillari G., Ciammaichella M., Di Micco P., Duce R., Maida R., Pasca S., Pesavento R., Piovaccari G., Piovella C., Poggio R., Prandoni P., Quintavalla R., Rota L., Schenone A., Tiraferri E., Tonello D., Tufano A., Visonà A., Zalunardo B., Barbosa AL., Gomes D., Gonçalves F., Santos M., Saraiva M., Bosevski M., Alatri A., Aujeski D., Bounameaux H., Calanca L., Mazzolai L.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Publication state
Published
Issued date
2013
Volume
132
Number
2
Pages
175-179
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish. A. Aalatri fait partie de RIETE Investigators
Abstract
BACKGROUND: The only available score to assess the risk for fatal bleeding in patients with venous thromboembolism (VTE) has not been validated yet.
METHODS: We used the RIETE database to validate the risk-score for fatal bleeding within the first 3 months of anticoagulation in a new cohort of patients recruited after the end of the former study. Accuracy was measured using the ROC curve analysis.
RESULTS: As of December 2011, 39,284 patients were recruited in RIETE. Of these, 15,206 had not been included in the former study, and were considered to validate the score. Within the first 3 months of anticoagulation, 52 patients (0.34%; 95% CI: 0.27-0.45) died of bleeding. Patients with a risk score of <1.5 points (64.1% of the cohort) had a 0.10% rate of fatal bleeding, those with a score of 1.5-4.0 (33.6%) a rate of 0.72%, and those with a score of >4 points had a rate of 1.44%. The c-statistic for fatal bleeding was 0.775 (95% CI 0.720-0.830). The score performed better for predicting gastrointestinal (c-statistic, 0.869; 95% CI: 0.810-0.928) than intracranial (c-statistic, 0.687; 95% CI: 0.568-0.806) fatal bleeding. The score value with highest combined sensitivity and specificity was 1.75. The risk for fatal bleeding was significantly increased (odds ratio: 7.6; 95% CI 3.7-16.2) above this cut-off value.
CONCLUSIONS: The accuracy of the score in this validation cohort was similar to the accuracy found in the index study. Interestingly, it performed better for predicting gastrointestinal than intracranial fatal bleeding.
METHODS: We used the RIETE database to validate the risk-score for fatal bleeding within the first 3 months of anticoagulation in a new cohort of patients recruited after the end of the former study. Accuracy was measured using the ROC curve analysis.
RESULTS: As of December 2011, 39,284 patients were recruited in RIETE. Of these, 15,206 had not been included in the former study, and were considered to validate the score. Within the first 3 months of anticoagulation, 52 patients (0.34%; 95% CI: 0.27-0.45) died of bleeding. Patients with a risk score of <1.5 points (64.1% of the cohort) had a 0.10% rate of fatal bleeding, those with a score of 1.5-4.0 (33.6%) a rate of 0.72%, and those with a score of >4 points had a rate of 1.44%. The c-statistic for fatal bleeding was 0.775 (95% CI 0.720-0.830). The score performed better for predicting gastrointestinal (c-statistic, 0.869; 95% CI: 0.810-0.928) than intracranial (c-statistic, 0.687; 95% CI: 0.568-0.806) fatal bleeding. The score value with highest combined sensitivity and specificity was 1.75. The risk for fatal bleeding was significantly increased (odds ratio: 7.6; 95% CI 3.7-16.2) above this cut-off value.
CONCLUSIONS: The accuracy of the score in this validation cohort was similar to the accuracy found in the index study. Interestingly, it performed better for predicting gastrointestinal than intracranial fatal bleeding.
Pubmed
Web of science
Open Access
Yes
Create date
11/02/2014 16:25
Last modification date
28/05/2020 5:26
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