A Clinical Prediction Rule for Thrombosis in Critically Ill COVID-19 Patients: Step 1 Results of the Thromcco Study

被引:1
|
作者
Ramirez Cervantes, Karen L. [1 ]
Mora, Elianne [2 ]
Campillo Morales, Salvador [1 ]
Huerta Alvarez, Consuelo [3 ]
Marcos Neira, Pilar [4 ]
Nanwani Nanwani, Kapil Laxman [5 ]
Serrano Lazaro, Ainhoa [6 ]
Silva Obregon, J. Alberto [7 ]
Quintana Diaz, Manuel [1 ,5 ]
机构
[1] Hosp La Paz Inst Hlth Res, Patient Blood Management Res Grp, Madrid 28040, Spain
[2] Charles III Univ Madrid, Dept Stat, Getafe 28903, Spain
[3] Univ Complutense Madrid, Fac Med, Dept Publ Hlth & Maternal & Child Hlth, Madrid 28040, Spain
[4] Hosp Badalona Germans Trias & Pujol, Intens Care Unit, Badalona 08916, Spain
[5] La Paz Univ Hosp, Intens Care Unit, Madrid 28040, Spain
[6] Clin Univ Hosp Valencia, Intens Care Unit, Valencia 46010, Spain
[7] Univ Hosp Guadalajara, Intens Care Unit, Guadalajara 19002, Spain
关键词
thrombosis; COVID-19; risk prediction model; clinical prediction rule; PULMONARY-EMBOLISM; VENOUS THROMBOEMBOLISM; SCORE; MODEL;
D O I
10.3390/jcm12041253
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The incidence of thrombosis in COVID-19 patients is exceptionally high among intensive care unit (ICU)-admitted individuals. We aimed to develop a clinical prediction rule for thrombosis in hospitalized COVID-19 patients. Data were taken from the Thromcco study (TS) database, which contains information on consecutive adults (aged >= 18) admitted to eight Spanish ICUs between March 2020 and October 2021. Diverse logistic regression model analysis, including demographic data, pre-existing conditions, and blood tests collected during the first 24 h of hospitalization, was performed to build a model that predicted thrombosis. Once obtained, the numeric and categorical variables considered were converted to factor variables giving them a score. Out of 2055 patients included in the TS database, 299 subjects with a median age of 62.4 years (IQR 51.5-70) (79% men) were considered in the final model (SE = 83%, SP = 62%, accuracy = 77%). Seven variables with assigned scores were delineated as age 25-40 and >= 70 = 12, age 41-70 = 13, male = 1, D-dimer >= 500 ng/mL = 13, leukocytes >= 10 x 10(3)/mu L = 1, interleukin-6 >= 10 pg/mL = 1, and C-reactive protein (CRP) >= 50 mg/L = 1. Score values >= 28 had a sensitivity of 88% and specificity of 29% for thrombosis. This score could be helpful in recognizing patients at higher risk for thrombosis, but further research is needed.
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页数:10
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