TY - JOUR
T1 - Development of a Risk Prediction Score for Occult Cancer in Patients With VTE
AU - Jara-Palomares, Luis
AU - Otero, Remedios
AU - Jimenez, David
AU - Carrier, Marc
AU - Tzoran, Inna
AU - Brenner, Benjamin
AU - Margeli, Mireia
AU - Praena-Fernandez, Juan Manuel
AU - Grandone, Elvira
AU - Monreal, Manuel
AU - RIETE Investigators
A2 - Decousus, Hervè
A2 - Prandoni, P.
A2 - Barba, Raquel
A2 - Di Micco, Pierpaolo
A2 - Bertoletti, Laurent
A2 - Reis, Abilio
A2 - Bosevski, Marijan
A2 - Bounameaux, Henri
A2 - Malý, Radovan
A2 - Wells, Philip
A2 - Papadakis, Manolis
A2 - Aibar, M. A.
A2 - Alfonso, M.
A2 - Asensio-Cruz, M. I.
A2 - Barrón, M.
A2 - Barrón-Andrés, B.
A2 - Cañas, I.
A2 - Ceausu, A.
A2 - Chic, N.
A2 - del Pozo, R.
A2 - del Toro, J.
A2 - Duffort, M.
A2 - Elias-Hernández, T.
A2 - Falgá, C.
A2 - Fidalgo, M. A.
A2 - Drucka, E.
A2 - Kigitovica, D.
A2 - Skride, A.
N1 - Publisher Copyright:
© 2016 American College of Chest Physicians
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background The benefits of a diagnostic workup for occult cancer in patients with VTE are controversial. Our aim was to provide and validate a risk score for occult cancer in patients with VTE. Methods We designed a nested case-control study in a cohort of patients with VTE included in the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry from 2001 to 2014. Cases included cancer detected beyond the first 30 days and up to 24 months after VTE. Control subjects were defined as patients with VTE with no cancer in the same period. Results Of 5,863 eligible patients, 444 (7.6%; 95% CI, 6.8%-8.2%) were diagnosed with occult cancer. On multivariable analysis, variables selected were male sex, age > 70 years, chronic lung disease, anemia, elevated platelet count, prior VTE, and recent surgery. We built a risk score assigning points to each variable. Internal validity was confirmed using bootstrap analysis. The proportion of patients with cancer who scored ≤ 2 points was 5.8% (241 of 4,150) and that proportion in those who scored ≥ 3 points was 12% (203 of 1,713). We also identified scores divided by sex and age subgroups. Conclusions This is the first risk score that has identified patients with VTE who are at increased risk for occult cancer. Our score needs to be externally validated.
AB - Background The benefits of a diagnostic workup for occult cancer in patients with VTE are controversial. Our aim was to provide and validate a risk score for occult cancer in patients with VTE. Methods We designed a nested case-control study in a cohort of patients with VTE included in the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry from 2001 to 2014. Cases included cancer detected beyond the first 30 days and up to 24 months after VTE. Control subjects were defined as patients with VTE with no cancer in the same period. Results Of 5,863 eligible patients, 444 (7.6%; 95% CI, 6.8%-8.2%) were diagnosed with occult cancer. On multivariable analysis, variables selected were male sex, age > 70 years, chronic lung disease, anemia, elevated platelet count, prior VTE, and recent surgery. We built a risk score assigning points to each variable. Internal validity was confirmed using bootstrap analysis. The proportion of patients with cancer who scored ≤ 2 points was 5.8% (241 of 4,150) and that proportion in those who scored ≥ 3 points was 12% (203 of 1,713). We also identified scores divided by sex and age subgroups. Conclusions This is the first risk score that has identified patients with VTE who are at increased risk for occult cancer. Our score needs to be externally validated.
KW - neoplasm
KW - pulmonary embolism
KW - risk
KW - screening
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85014572550&partnerID=8YFLogxK
UR - https://www.riete.org/info/centros_participantes/index.php
U2 - 10.1016/j.chest.2016.10.025
DO - 10.1016/j.chest.2016.10.025
M3 - Article
C2 - 27815153
AN - SCOPUS:85014572550
SN - 0012-3692
VL - 151
SP - 564
EP - 571
JO - Chest
JF - Chest
IS - 3
ER -
