A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity.
Details
Serval ID
serval:BIB_4E95F9F3518B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity.
Journal
Journal of Thrombosis and Haemostasis : Jth
Working group(s)
RIETE Investigators
Contributor(s)
Decousus H., Prandoni P., Brenner B., Barba R., Di Micco P., Bertoletti L., Schellong S., Tzoran I., Reis A., Bosevski M., Bounameaux H., Wells P., Papadakis M., Adarraga MD., Alibalic A., Alvarado-Faria A., Arcelus JI., Auguet T., Ballaz A., Barrón M., Barrón-Andrés B., Bascuñana J., Benítez JF., Blanco-Molina A., Bueso T., Cañas A., Casado A., Castejón-Pina N., Chaves EL., Del Molino F., Del Toro J., Falgá C., Fernández-Capitán C., Font L., Gallego P., García-Bragado F., García-Ortega A., Gómez V., González J., González-Marcano D., Grau E., Guijarro R., Guil M., Guirado L., Gutiérrez-Guisado J., Hernández-Blasco L., Jara-Palomares L., Jaras MJ., Jiménez D., Jiménez R., Lacruz B., Lecumberri R., Lobo JL., López-Jiménez L., López-Montes L., López-Reyes R., López-Sáez JB., Lorente MA., Lorenzo A., Madridano O., Maestre A., Marchena PJ., Martín-Antorán JM., Martín-Martos F., Morales MV., Nauffal D., Nieto JA., Núñez MJ., Otalora S., Otero R., Pagán B., Pedrajas JM., Peris ML., Pons I., Porras JA., Riera-Mestre A., Rivas A., Rodríguez-Dávila MA., Ruiz-Giménez N., Sabio P., Sampériz A., Sánchez R., Soto MJ., Suriñach JM., Tiberio G., Tirado R., Tolosa C., Uresandi F., Valero B., Valle R., Vela J., Villalobos A., Villalta J., Malfante P., Verhamme P., Vanassche T., Tomko T., Hirmerova J., Bura-Riviere A., Farge-Bancel D., Hij A., Mahe I., Merah A., Moustafa F., Quere I., Babalis D., Tzinieris I., Braester A., Barillari G., Bucherini E., Campodomico J., Ciammaichella M., Ferrazzi P., Maida R., Pace F., Pasca S., Pesavento R., Piovella C., Rota L., Tiraferri E., Tufano A., Visonà A., Skride A., Belovs A., Moreira M., Ribeiro JL., Sousa MS., Alatri A., Calanca L., Mazzolai L.
ISSN
1538-7836 (Electronic)
ISSN-L
1538-7836
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
13
Number
7
Pages
1274-1278
Language
english
Notes
Alatri A. is a RIETE investigator
Abstract
BACKGROUND: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy.
METHODS: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week.
RESULTS: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min(-1) , recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels < 30 mL min(-1) . Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055.
CONCLUSIONS: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.
METHODS: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week.
RESULTS: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min(-1) , recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels < 30 mL min(-1) . Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055.
CONCLUSIONS: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.
Pubmed
Web of science
Open Access
Yes
Create date
12/02/2016 13:49
Last modification date
28/05/2020 5:26
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