Validation of clinical risk assessment scores for venous thromboembolism in patients with cancer: a population-based cohort study.

IF 5.5 2区 医学 Q1 HEMATOLOGY Journal of Thrombosis and Haemostasis Pub Date : 2024-10-29 DOI:10.1016/j.jtha.2024.10.021
Vincent Lanting, Emese Vágó, Erzsébet Horváth-Puhó, Frits Mulder, Marcello Di Nisio, Pieter W Kamphuisen, Lars Pedersen, Nick van Es, Henrik T Sørensen
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Abstract

Background: Guidelines recommend using risk assessment tools to identify ambulatory patients with cancer at high risk of venous thromboembolism (VTE).

Objective: We aimed to validate a new cancer-associated thrombosis (CAT) risk score in a population-based healthcare setting.

Methods: We used healthcare registry data and electronic medical records from the Central Denmark Region to calculate the new CAT risk score and the guideline-recommended Khorana score in patients with a first-time cancer diagnosis who initiated systemic cancer therapy. Patients were followed for six months after initiation of therapy. The outcome was any VTE identified through hospital discharge diagnoses. Discrimination was assessed using c-statistics.

Results: We included 12,471 patients from 2012 through 2020. Of these, 416 (3.3%) developed VTE. The c-statistic was 0.71 (95% confidence interval [CI]: 0.68-0.74) for the new CAT score and 0.66 (95% CI: 0.63-0.70) for the Khorana score. The six-month cumulative VTE incidence was 5.0% in 6,175 patients classified as high risk by the new CAT score, compared with 1.7% in 6,296 patients classified as low risk. The six-month cumulative VTE incidence was 5.2% in 4,263 patients classified as high risk by the Khorana score, compared with 2.4% in 8,208 patients classified as low risk.

Conclusion: The new CAT score had a discriminatory ability similar to that reported in the derivation study. The c-statistic was numerically higher than that of the Khorana score. Our findings support implementation of the new CAT score to identify ambulatory patients with cancer who are at high risk of VTE.

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癌症患者静脉血栓栓塞临床风险评估评分的验证:一项基于人群的队列研究。
背景:指南建议使用风险评估工具来识别静脉血栓栓塞症(VTE)高风险的非卧床癌症患者:我们的目的是在基于人群的医疗环境中验证新的癌症相关血栓形成(CAT)风险评分:我们利用丹麦中部地区的医疗登记数据和电子病历,计算了首次诊断为癌症并开始接受系统性癌症治疗的患者的新 CAT 风险评分和指南推荐的 Khorana 评分。在开始治疗后,对患者进行了为期 6 个月的随访。结果为出院诊断中发现的任何 VTE。使用c统计量评估识别率:我们纳入了 2012 年至 2020 年期间的 12,471 名患者。其中,416 人(3.3%)发生了 VTE。新CAT评分的c统计量为0.71(95%置信区间[CI]:0.68-0.74),Khorana评分的c统计量为0.66(95%置信区间[CI]:0.63-0.70)。根据新的CAT评分被归类为高风险的6175名患者的6个月累积VTE发生率为5.0%,而被归类为低风险的6296名患者的6个月累积VTE发生率为1.7%。在4,263名被霍拉娜评分归为高风险的患者中,6个月累计VTE发生率为5.2%,而在8,208名被归为低风险的患者中,6个月累计VTE发生率为2.4%:新的CAT评分的判别能力与衍生研究中的报告相似。c统计量在数值上高于霍拉娜评分。我们的研究结果支持采用新的 CAT 评分来识别 VTE 高风险的非卧床癌症患者。
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来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
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