Subject: Venous thromboembolism
Subject: decision support techniques
Subject: neoplasms
Subject: recurrence
Subject: venous thrombosis
Year: 2017
Type: Article
Title: Low discriminating power of the modified Ottawa VTE risk score in a cohort of patients with cancer from the RIETE registry
Author: Alatri A
Author: Mazzolai L
Author: Font C
Author: Tafur A
Author: Valle R
Author: Marchena PJ
Author: Ballaz A
Author: Tiraferri E
Author: Font L
Author: Monreal M
Author: Riete Investigators
Author: Bosevski M
Author: Zdraveska M
Abstract: Treatment of patients with cancer-associated venous thromboembolism (VTE) remains a major challenge. The modified Ottawa score is a clinical prediction rule evaluating the risk of VTE recurrences during the first six months of anticoagulant treatment in patients with cancer-related VTE. We aimed to validate the Ottawa score using data from the RIETE registry. A total of 11,123 cancer patients with VTE were included in the analysis. According to modified Ottawa score, 2,343 (21 %) were categorised at low risk for VTE recurrences, 4,525 (41 %) at intermediate risk, and 4,255 (38 %) at high risk. Overall, 477 episodes of VTE recurrences were recorded during the course of anticoagulant therapy, with an incidence rate for low, intermediate, and high risk groups of 6.88 % (95 % CI 5.31-8.77), 11.8 % (95 % CI 10.1-13.6), and 21.3 % (95 % CI 18.8-24.1) patient-years, respectively. Overall mortality had an incidence rate of 21.1 % (95 % CI 18.2-24.3), 79.4 % (95 % CI: 74.9-84.1), and 134.7 % (95 % CI: 128.3-141.4) patient-years, respectively. The accuracy and discriminating power of the modified Ottawa score for VTE recurrence was modest, with low sensitivity, specificity and positive predictive value, and a C-statistics of 0.58 (95 % CI: 0.56-0.61). In our analysis, the modified Ottawa score did not accurately predict VTE recurrence among patients with cancer-associated thrombosis, thus hindering its use in clinical practice. It is time to define a new score including other clinical predictors.
Publisher: Thieme Medical Publishers
Relation: Thrombosis and Haemostasis
Identifier: oai:repository.ukim.mk:20.500.12188/29183
Identifier: 8. Alatri A, Mazzolai L, Font C, Tafur A, Valle R, Marchena PJ, Ballaz A, Tiraferri E, Font L, Monreal M, Riete Investigators, Low discriminating power of the modified Ottawa VTE risk score in a cohort of patients with cancer from the RIETE registry. Thromb Haemost. 2017 Jul 26;117(8):1630-1636.
Identifier: http://hdl.handle.net/20.500.12188/29183Identifier: 10.1160/TH17-02-0116
