Evaluating of Existing VTE Risk Scales in Glioma Patients

Introduction Postoperative venous thromboembolism (VTE) is a frequently occurring complication among glioma patients. Several risk assessment models (RAMs), including the Caprini RAM, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score, have not been validated within...

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Main Authors: Simakova Maria MD, PhD, Pishchulov Konstantin MD, Lukinov Vitaliy PhD, Voynov Nikita MD, Bulaeva Maria MD, Melnichnikova Olga MD, PhD, Zhilenkova Yulia MD, PhD, Savelyeva Аnna MD, Moiseeva Olga MD, PhD, Samochernykh Konstantin MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2024-04-01
Series:Clinical and Applied Thrombosis/Hemostasis
Online Access:https://doi.org/10.1177/10760296241238210
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author Simakova Maria MD, PhD
Pishchulov Konstantin MD
Lukinov Vitaliy PhD
Voynov Nikita MD
Bulaeva Maria MD
Melnichnikova Olga MD, PhD
Zhilenkova Yulia MD, PhD
Savelyeva Аnna MD
Moiseeva Olga MD, PhD
Samochernykh Konstantin MD, PhD
author_facet Simakova Maria MD, PhD
Pishchulov Konstantin MD
Lukinov Vitaliy PhD
Voynov Nikita MD
Bulaeva Maria MD
Melnichnikova Olga MD, PhD
Zhilenkova Yulia MD, PhD
Savelyeva Аnna MD
Moiseeva Olga MD, PhD
Samochernykh Konstantin MD, PhD
author_sort Simakova Maria MD, PhD
collection DOAJ
description Introduction Postoperative venous thromboembolism (VTE) is a frequently occurring complication among glioma patients. Several risk assessment models (RAMs), including the Caprini RAM, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score, have not been validated within the glioma patient population. The purpose of this study was to assess the predictive accuracy of established VTE risk scales in patients with glioma. Materials and Methods A single-center, retrospective, observational cohort study was conducted on 265 glioma patients who underwent surgery at the Almazov Medical and Research Centre between 2021 and 2022. VTE detection followed the current clinical guidelines. Threshold values for the Caprini, IMPROVE VTE, IMPROVEDD, and Padua scales were determined using ROC analysis methods, with cumulative weighting for sensitivity and specificity in predicting VTE development. The areas under the ROC curves (AUC) were calculated, and comparisons were made using the DeLong test. Results The area under the curve for the Caprini risk assessment model was 80.41, while the IMPROVEDD VTE risk score was 75.38, the Padua prediction score was 76.9, and the IMPROVE risk score was 72.58. No significant differences were observed in the AUC values for any of the scales. The positive predictive values of all four scales were low, with values of 50 (28–72) for Caprini, 48 (28–69) for IMPROVEDD VTE, 50 (30–70) for Padua, and 64 (35–87) for IMPROVE RAM. No significant differences were found in terms of PPV, NPV, positive likelihood ratio, and negative likelihood ratio among the analyzed scales. Conclusions The Caprini Risk Assessment Model, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score exhibit acceptable specificity and sensitivity for glioma patients. However, their low positive predictive ability, coupled with the complexity of interpretation, limits their utility in neurosurgical practice.
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spelling doaj.art-37b1895d9c3442eba3d7fd5d60e0c05e2024-04-03T10:03:32ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232024-04-013010.1177/10760296241238210Evaluating of Existing VTE Risk Scales in Glioma PatientsSimakova Maria MD, PhD0Pishchulov Konstantin MD1Lukinov Vitaliy PhD2Voynov Nikita MD3Bulaeva Maria MD4Melnichnikova Olga MD, PhD5Zhilenkova Yulia MD, PhD6Savelyeva Аnna MD7Moiseeva Olga MD, PhD8Samochernykh Konstantin MD, PhD9 Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Personalized Medicine Centre, Almazov National Medical Research Centre, Sankt-Peterburg, Russian Federation Almazov National Medical Research Centre, Sankt-Peterburg, Russian Federation Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Cardiolooncology Department, Personalized Medicine Centre, , Sankt-Peterburg, Russian Federation Department of Hearth and Vessel Institute Almazov National Medical Research Centre, Sankt-Peterburg, Russian Federation Oncology department Personalized Medicine Centre Almazov National Medical Research Centre, Sankt-Peterburg, Russian FederationIntroduction Postoperative venous thromboembolism (VTE) is a frequently occurring complication among glioma patients. Several risk assessment models (RAMs), including the Caprini RAM, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score, have not been validated within the glioma patient population. The purpose of this study was to assess the predictive accuracy of established VTE risk scales in patients with glioma. Materials and Methods A single-center, retrospective, observational cohort study was conducted on 265 glioma patients who underwent surgery at the Almazov Medical and Research Centre between 2021 and 2022. VTE detection followed the current clinical guidelines. Threshold values for the Caprini, IMPROVE VTE, IMPROVEDD, and Padua scales were determined using ROC analysis methods, with cumulative weighting for sensitivity and specificity in predicting VTE development. The areas under the ROC curves (AUC) were calculated, and comparisons were made using the DeLong test. Results The area under the curve for the Caprini risk assessment model was 80.41, while the IMPROVEDD VTE risk score was 75.38, the Padua prediction score was 76.9, and the IMPROVE risk score was 72.58. No significant differences were observed in the AUC values for any of the scales. The positive predictive values of all four scales were low, with values of 50 (28–72) for Caprini, 48 (28–69) for IMPROVEDD VTE, 50 (30–70) for Padua, and 64 (35–87) for IMPROVE RAM. No significant differences were found in terms of PPV, NPV, positive likelihood ratio, and negative likelihood ratio among the analyzed scales. Conclusions The Caprini Risk Assessment Model, the IMPROVE Risk Score, the IMPROVED VTE Risk Score, and the Padua Prediction Score exhibit acceptable specificity and sensitivity for glioma patients. However, their low positive predictive ability, coupled with the complexity of interpretation, limits their utility in neurosurgical practice.https://doi.org/10.1177/10760296241238210
spellingShingle Simakova Maria MD, PhD
Pishchulov Konstantin MD
Lukinov Vitaliy PhD
Voynov Nikita MD
Bulaeva Maria MD
Melnichnikova Olga MD, PhD
Zhilenkova Yulia MD, PhD
Savelyeva Аnna MD
Moiseeva Olga MD, PhD
Samochernykh Konstantin MD, PhD
Evaluating of Existing VTE Risk Scales in Glioma Patients
Clinical and Applied Thrombosis/Hemostasis
title Evaluating of Existing VTE Risk Scales in Glioma Patients
title_full Evaluating of Existing VTE Risk Scales in Glioma Patients
title_fullStr Evaluating of Existing VTE Risk Scales in Glioma Patients
title_full_unstemmed Evaluating of Existing VTE Risk Scales in Glioma Patients
title_short Evaluating of Existing VTE Risk Scales in Glioma Patients
title_sort evaluating of existing vte risk scales in glioma patients
url https://doi.org/10.1177/10760296241238210
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