A clinical prognostic model for the identification of low-risk patients with acute symptomatic pulmonary embolism and active cancer.
Details
Serval ID
serval:BIB_51871E808374
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A clinical prognostic model for the identification of low-risk patients with acute symptomatic pulmonary embolism and active cancer.
Journal
Chest
Working group(s)
Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) Investigators
Contributor(s)
Monreal M., Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Papadakis M., Bosevski M., Bounameaux H., Malý R., Arcelus JI., Arcos MP., Ballaz A., Barba R., Barrón M., Barrón-Andrés B., Blanco-Molina A., Boix L., Bosco J., Bueso T., Campano F., Cañas I., Casado I., Conget F., de Miguel J., del Campo R., Chaves E., del Toro J., Falgá C., Fernández-Capitán C., Gabriel F., Gallego P., García-Bragado F., Gavín O., Gómez V., González J., Gracia V., Guil M., Guillem N., Gutiérrez J., Hernández L., Hernández-Huerta D., Jaras MJ., Jiménez D., Jiménez S., Jiménez-Gil M., Lobo JL., Lecumberri R., López-Jiménez L., Lorenzo A., Macià M., Madridano O., Marchena PJ., Martín M., Martín-Villasclaras JJ., Mejías I., Monreal M., Montero L., Morales M., Nauffal MD., Nieto JA., Núñez MJ., Ogea JL., Otero R., Pedrajas JM., Riera-Mestre A., Rodríguez-Dávila MA., Román P., Román-Bernal B., Roldán V., Rosa V., Royo C., Ruíz J., Ruiz-Gamietea A., Ruiz-Giménez N., Sahuquillo JC., Sánchez R., Sánchez Muñoz-Torrero JF. , Soler S., Soto MJ., Tiberio G., Tirado R., Tolosa C., Trujillo J., Uresandi F., Valdés M., Valle R., Vela J., Vidal G., Villalta J., Zorrilla V., Bertoletti L., Bura-Riviere A., Debourdeau P., Farge-Bancel D., Lamuraglia M., Mahe I., Quere I., Babalis D., Papadakis M., Brenner B., Barillari G., Ciammaichella M., Di Micco P., Dalla Valle F., Duce R., La Regina M., Maida R., Orlandini F., Pasca S., Piovella C., Poggio R., Prandoni P., Quintavalla R., Rota L., Schenone A., Tonello D., Visonà A., Zalunardo B., Bosevski M., Alatri A., Bounameaux H., Calanca L., Mazzolai L., Malý R., Hirmerova J., Tomko T., Salgado E.
ISSN
1931-3543 (Electronic)
ISSN-L
0012-3692
Publication state
Published
Issued date
2013
Volume
143
Number
1
Pages
138-145
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
BACKGROUND: Physicians need a specific risk-stratification tool to facilitate safe and cost-effective approaches to the management of patients with cancer and acute pulmonary embolism (PE). The objective of this study was to develop a simple risk score for predicting 30-day mortality in patients with PE and cancer by using measures readily obtained at the time of PE diagnosis.
METHODS: Investigators randomly allocated 1,556 consecutive patients with cancer and acute PE from the international multicenter Registro Informatizado de la Enfermedad TromboEmbólica to derivation (67%) and internal validation (33%) samples. The external validation cohort for this study consisted of 261 patients with cancer and acute PE. Investigators compared 30-day all-cause mortality and nonfatal adverse medical outcomes across the derivation and two validation samples.
RESULTS: In the derivation sample, multivariable analyses produced the risk score, which contained six variables: age > 80 years, heart rate ≥ 110/min, systolic BP < 100 mm Hg, body weight < 60 kg, recent immobility, and presence of metastases. In the internal validation cohort (n = 508), the 22.2% of patients (113 of 508) classified as low risk by the prognostic model had a 30-day mortality of 4.4% (95% CI, 0.6%-8.2%) compared with 29.9% (95% CI, 25.4%-34.4%) in the high-risk group. In the external validation cohort, the 18% of patients (47 of 261) classified as low risk by the prognostic model had a 30-day mortality of 0%, compared with 19.6% (95% CI, 14.3%-25.0%) in the high-risk group.
CONCLUSIONS: The developed clinical prediction rule accurately identifies low-risk patients with cancer and acute PE.
METHODS: Investigators randomly allocated 1,556 consecutive patients with cancer and acute PE from the international multicenter Registro Informatizado de la Enfermedad TromboEmbólica to derivation (67%) and internal validation (33%) samples. The external validation cohort for this study consisted of 261 patients with cancer and acute PE. Investigators compared 30-day all-cause mortality and nonfatal adverse medical outcomes across the derivation and two validation samples.
RESULTS: In the derivation sample, multivariable analyses produced the risk score, which contained six variables: age > 80 years, heart rate ≥ 110/min, systolic BP < 100 mm Hg, body weight < 60 kg, recent immobility, and presence of metastases. In the internal validation cohort (n = 508), the 22.2% of patients (113 of 508) classified as low risk by the prognostic model had a 30-day mortality of 4.4% (95% CI, 0.6%-8.2%) compared with 29.9% (95% CI, 25.4%-34.4%) in the high-risk group. In the external validation cohort, the 18% of patients (47 of 261) classified as low risk by the prognostic model had a 30-day mortality of 0%, compared with 19.6% (95% CI, 14.3%-25.0%) in the high-risk group.
CONCLUSIONS: The developed clinical prediction rule accurately identifies low-risk patients with cancer and acute PE.
Keywords
Age Factors, Aged, Aged, 80 and over, Cohort Studies, Decision Support Techniques, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasms/complications, Neoplasms/mortality, Prognosis, Pulmonary Embolism/complications, Pulmonary Embolism/diagnosis, Random Allocation, Reproducibility of Results, Retrospective Studies, Risk Assessment/methods, Risk Factors, Severity of Illness Index
Pubmed
Web of science
Create date
14/02/2013 12:22
Last modification date
20/08/2019 14:07
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