Publication:
Comparative Performance of Clinical Risk Assessment Models for Hospital-Acquired Venous Thromboembolism in Medical Patients.

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dc.contributor.authorBlondon, Marc
dc.contributor.authorSpirk, David
dc.contributor.authorKucher, Nils
dc.contributor.authorAujesky, Drahomir
dc.contributor.authorHayoz, Daniel
dc.contributor.authorBeer, Jürg H
dc.contributor.authorHusmann, Marc
dc.contributor.authorFrauchiger, Beat
dc.contributor.authorKorte, Wolfgang
dc.contributor.authorWuillemin, Walter Alfred
dc.contributor.authorBounameaux, Henri
dc.contributor.authorRighini, Marc
dc.contributor.authorNendaz, Mathieu
dc.date.accessioned2024-10-07T16:54:15Z
dc.date.available2024-10-07T16:54:15Z
dc.date.issued2018-01
dc.description.abstractBACKGROUND Improved thromboprophylaxis for acutely ill medical patients relies on valid predictions of thrombotic risks. Our aim was to compare the performance of the Improve and Geneva clinical risk assessment models (RAMs), and to simplify the current Geneva RAM. METHODS Medical inpatients from eight Swiss hospitals were prospectively followed during 90 days, for symptomatic venous thromboembolism (VTE) or VTE-related death. We compared discriminative performance and calibration of the RAMs, using time-to-event methods with competing risk modelling of non-VTE death. RESULTS In 1,478 patients, the 90-day VTE cumulative incidence was 1.6%. Discrimination of the Improve and Geneva RAM was similar, with a 30-day AUC (areas under the curve) of 0.78 (95% CI [confidence interval]: 0.65-0.92) and 0.81 (0.73-0.89), respectively. According to the Improve RAM, 68% of participants were at low risk (0.8% VTE at 90 days), and 32% were at high risk (4.7% VTE), with a sensitivity of 73%. According to the Geneva RAM, 35% were at low risk (0.6% VTE) and 65% were at high risk (2.8% VTE), with a sensitivity of 90%. Among patients without thromboprophylaxis, the sensitivity was numerically greater in the Geneva RAM (85%) than in the Improve RAM (54%). We derived a simplified Geneva RAM with comparable discrimination and calibration as the original Geneva RAM. CONCLUSIONS We found comparably good discrimination of the Improve and Geneva RAMs. The Improve RAM classified more patients as low risk, but with possibly lower sensitivity and greater VTE risks, suggesting that a lower threshold for low risk (<2) should be used. The simplified Geneva RAM may represent an alternative to the Geneva RAM with enhanced usability.
dc.description.numberOfPages8
dc.description.sponsorshipLehrkörper, Medizinische Fakultät
dc.description.sponsorshipUniversitätsklinik für Allgemeine Innere Medizin
dc.description.sponsorshipInstitut für Pharmakologie
dc.description.sponsorshipDepartment for BioMedical Research, Forschungsgruppe Angiologie
dc.identifier.doi10.7892/boris.123167
dc.identifier.pmid29304528
dc.identifier.publisherDOI10.1160/TH17-06-0403
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/62024
dc.language.isoen
dc.publisherSchattauer
dc.relation.ispartofThrombosis and haemostasis
dc.relation.issn0340-6245
dc.relation.organizationDCD5A442BD11E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442C058E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442C2B2E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442C44DE17DE0405C82790C4DE2
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleComparative Performance of Clinical Risk Assessment Models for Hospital-Acquired Venous Thromboembolism in Medical Patients.
dc.typearticle
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oaire.citation.endPage89
oaire.citation.issue1
oaire.citation.startPage82
oaire.citation.volume118
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oairecerif.author.affiliationInstitut für Pharmakologie
oairecerif.author.affiliationDepartment for BioMedical Research, Forschungsgruppe Angiologie
oairecerif.author.affiliationUniversitätsklinik für Allgemeine Innere Medizin
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oairecerif.author.affiliationLehrkörper, Medizinische Fakultät
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oairecerif.author.affiliation2Universitätsklinik für Angiologie
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unibe.date.licenseChanged2019-11-12 23:10:39
unibe.description.ispublishedpub
unibe.eprints.legacyId123167
unibe.journal.abbrevTitleTHROMB HAEMOSTASIS
unibe.refereedTRUE
unibe.subtype.articlejournal

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