Validation of Risk Assessment Models Predicting Venous Thromboembolism in Inpatients with Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Multicenter Cohort Study in China

Chen Zhou; Qun Yi; Huiqing Ge; Hailong Wei; Huiguo Liu; Jianchu Zhang; Yuanming Luo; Pinhua Pan; Jiarui Zhang; Lige Peng; Adila Aili; Yu Liu; Maoyun Wang; Yongjiang Tang; Lan Wang; Xia Zhong; Yixi Wang; Haixia Zhou; On behalf of the MAGNET AECOPD Registry Investigators

doi:10.1055/a-1693-0063

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2022; 122(07): 1177-1185
DOI: 10.1055/a-1693-0063

Stroke, Systemic or Venous Thromboembolism

Validation of Risk Assessment Models Predicting Venous Thromboembolism in Inpatients with Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Multicenter Cohort Study in China

Chen Zhou^*

¹West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Qun Yi^*

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Huiqing Ge

³Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China

,

Hailong Wei

⁴Department of Respiratory and Critical Care Medicine, People's Hospital of Leshan, Leshan, Sichuan Province, China

,

Huiguo Liu

⁵Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China

,

Jianchu Zhang

⁶Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China

,

Yuanming Luo

⁷State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, China

,

Pinhua Pan

⁸Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

,

Jiarui Zhang

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Lige Peng

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Adila Aili

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Yu Liu

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Maoyun Wang

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Yongjiang Tang

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Lan Wang

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Xia Zhong

¹West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Yixi Wang

¹West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

Haixia Zhou

²Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

,

On behalf of the MAGNET AECOPD Registry Investigators

› Author Affiliations

Abstract

Background Inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at increased risk for venous thromboembolism (VTE); however, the prophylaxis for VTE is largely underused in China. Identifying high-risk patients requiring thromboprophylaxis is critical to reduce the mortality and morbidity associated with VTE. This study aimed to evaluate and compare the validities of the Padua Prediction Score and Caprini risk assessment model (RAM) in predicting the risk of VTE in inpatients with AECOPD in China.

Methods The inpatients with AECOPD were prospectively enrolled from seven medical centers of China between September 2017 and January 2020. Caprini and Padua scores were calculated on admission, and the incidence of 3-month VTE was investigated.

Results Among the 3,277 eligible patients with AECOPD, 128 patients (3.9%) developed VTE within 3 months after admission. The distribution of the study population by the Caprini risk level was as follows: high, 53.6%; moderate, 43.0%; and low, 3.5%. The incidence of VTE increased by risk level as high, 6.1%; moderate, 1.5%; and low, 0%. According to the Padua RAM, only 10.9% of the study population was classified as high risk and 89.1% as low risk, with the corresponding incidence of VTE of 7.9 and 3.4%, respectively. The Caprini RAM had higher area under curve compared with the Padua RAM (0.713 ± 0.021 vs. 0.644 ± 0.023, p = 0.029).

Conclusion The Caprini RAM was superior to the Padua RAM in predicting the risk of VTE in inpatients with AECOPD and might better guide thromboprophylaxis in these patients.

Keywords

acute exacerbation of chronic obstructive pulmonary disease - Caprini risk assessment model - inpatients - Padua Prediction Score - venous thromboembolism

Full Text

References

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Supplementary Material