Prediction of early mortality in patients with cancer-associated thrombosis in the RIETE Database

RIETE Investigators, Harry E Fuentes, Andris Skride (Member of the Working Group)

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

BACKGROUND: Proper risk stratification of patients for early mortality after cancer-associated thrombosis may lead to personalized anticoagulation protocols. Therefore, we aimed to derive and validate a scoring system to predict early mortality in this population. To this end, we selected patients with active cancer and thrombosis from the Computerized Registry of Patients with Venous Thromboembolism database.

METHODS: The main outcome was all cause mortality within the month following a thrombotic event. We used a simple random selection to split are data in a derivation and a validation cohort. In the derivation cohort, we used recursive partitioning and binary logistic regression to identify groups at risk and to determine the likelihood of the primary outcome. The risk score was developed based on odds ratios from the final multivariate model, and then tested in the validation cohort.

RESULTS: In 10,025 eligible patients, we identified 6 predictors of 30-day mortality: leukocytosis ≥11.5x109/L; platelet count ≤160x109/L, metastasis, recent immobility, initial presentation as pulmonary embolism and Body Mass Index <18.5. The model divided the population into 3 risk categories: low (score 0-3), moderate (score 4-6), and high (score ≥7). The AUC for the overall score was 0.74, and using a cutoff ≥7 points, the model had a negative predictive value of 94.4%, a positive predictive value of 23.1%, a sensitivity of 73.3%, and a specificity of 64.6% in the validation cohort.

CONCLUSIONS: Our validated risk model may assist physicians in the selection of patients for outpatient management, and perhaps anticoagulant, considering expanding anticoagulation options.

Original languageEnglish
Pages (from-to)173-184
Number of pages12
JournalInternational Angiology
Volume38
Issue number3
DOIs
Publication statusPublished - Jun 2019
Externally publishedYes

Keywords*

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Internationality
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms/complications
  • Predictive Value of Tests
  • Registries
  • Risk Assessment
  • Risk Factors
  • Thrombosis/diagnosis
  • Venous Thromboembolism/diagnosis
  • Young Adult

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

Fingerprint

Dive into the research topics of 'Prediction of early mortality in patients with cancer-associated thrombosis in the RIETE Database'. Together they form a unique fingerprint.

Cite this