Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19
Abstract Background Venous thromboembolism (VTE) risk is increased in patients with COVID‐19 infection. Understanding which patients are likely to develop VTE may inform pharmacologic VTE prophylaxis decision making. The hospital‐associated venous thromboembolism–Intermountain Risk Score (HA‐VTE IMR...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12765 |
| _version_ | 1827880489795452928 |
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| author | Scott C. Woller Scott M. Stevens Joseph R. Bledsoe Masarret Fazili James F. Lloyd Greg L. Snow Benjamin D. Horne |
| author_facet | Scott C. Woller Scott M. Stevens Joseph R. Bledsoe Masarret Fazili James F. Lloyd Greg L. Snow Benjamin D. Horne |
| author_sort | Scott C. Woller |
| collection | DOAJ |
| description | Abstract Background Venous thromboembolism (VTE) risk is increased in patients with COVID‐19 infection. Understanding which patients are likely to develop VTE may inform pharmacologic VTE prophylaxis decision making. The hospital‐associated venous thromboembolism–Intermountain Risk Score (HA‐VTE IMRS) and the hospital‐associated major bleeding–Intermountain Risk Score (HA‐MB IMRS) are risk scores predictive of VTE and bleeding that were derived from only patient age and data found in the complete blood count (CBC) and basic metabolic panel (BMP). Objectives We assessed the HA‐VTE IMRS and HA‐MB IMRS for predictiveness of 90‐day VTE and major bleeding, respectively, among patients diagnosed with COVID‐19, and further investigated if adding D‐dimer improved these predictions. We also reported 30‐day outcomes. Patients/Methods We identified 5047 sequential patients with a laboratory confirmed diagnosis of COVID‐19 and a CBC and BMP between 2 days before and 7 days following the diagnosis of COVID‐19 from March 12, 2020, to February 28, 2021. We calculated the HA‐VTE IMRS and the HA‐MB IMRS for all patients. We assessed the added predictiveness of D‐dimer obtained within 48 hours of the COVID test. Results The HA‐VTE IMRS yielded a c‐statistic of 0.70 for predicting 90‐day VTE and adding D‐dimer improved the c‐statistic to 0.764 with the corollary sensitivity/specificity/positive/negative predictive values of 49.4%/75.7%/6.7%/97.7% and 58.8%/76.2%/10.9%/97.4%, respectively. Among hospitalized and ambulatory patients separately, the HA‐VTE IMRS performed similarly. The HA‐MB IMRS predictiveness for 90‐day major bleeding yielded a c‐statistic of 0.64. Conclusion The HA‐VTE IMRS and HA‐MB IMRS predict 90‐ and 30‐day VTE and major bleeding among COVID‐19 patients. Adding D‐dimer improved the predictiveness of the HA‐VTE IMRS for VTE. |
| first_indexed | 2024-03-12T18:23:58Z |
| format | Article |
| id | doaj.art-7d1cee9382554ca3b137e2cf5f768a82 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T18:23:58Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-7d1cee9382554ca3b137e2cf5f768a822023-08-02T08:38:58ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792022-07-0165n/an/a10.1002/rth2.12765Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19Scott C. Woller0Scott M. Stevens1Joseph R. Bledsoe2Masarret Fazili3James F. Lloyd4Greg L. Snow5Benjamin D. Horne6Department of Medicine Intermountain Medical Center, Intermountain Healthcare Murray Utah USADepartment of Medicine Intermountain Medical Center, Intermountain Healthcare Murray Utah USADepartment of Emergency Medicine, Intermountain Medical Center Intermountain Healthcare Murray Utah USADepartment of Medicine Intermountain Medical Center, Intermountain Healthcare Murray Utah USADepartment of Informatics Intermountain Medical Center, Intermountain Healthcare Murray Utah USAIntermountain Statistical Data Center, Intermountain Medical Center Intermountain Healthcare Murray Utah USAIntermountain Medical Center Heart Institute Murray Utah USAAbstract Background Venous thromboembolism (VTE) risk is increased in patients with COVID‐19 infection. Understanding which patients are likely to develop VTE may inform pharmacologic VTE prophylaxis decision making. The hospital‐associated venous thromboembolism–Intermountain Risk Score (HA‐VTE IMRS) and the hospital‐associated major bleeding–Intermountain Risk Score (HA‐MB IMRS) are risk scores predictive of VTE and bleeding that were derived from only patient age and data found in the complete blood count (CBC) and basic metabolic panel (BMP). Objectives We assessed the HA‐VTE IMRS and HA‐MB IMRS for predictiveness of 90‐day VTE and major bleeding, respectively, among patients diagnosed with COVID‐19, and further investigated if adding D‐dimer improved these predictions. We also reported 30‐day outcomes. Patients/Methods We identified 5047 sequential patients with a laboratory confirmed diagnosis of COVID‐19 and a CBC and BMP between 2 days before and 7 days following the diagnosis of COVID‐19 from March 12, 2020, to February 28, 2021. We calculated the HA‐VTE IMRS and the HA‐MB IMRS for all patients. We assessed the added predictiveness of D‐dimer obtained within 48 hours of the COVID test. Results The HA‐VTE IMRS yielded a c‐statistic of 0.70 for predicting 90‐day VTE and adding D‐dimer improved the c‐statistic to 0.764 with the corollary sensitivity/specificity/positive/negative predictive values of 49.4%/75.7%/6.7%/97.7% and 58.8%/76.2%/10.9%/97.4%, respectively. Among hospitalized and ambulatory patients separately, the HA‐VTE IMRS performed similarly. The HA‐MB IMRS predictiveness for 90‐day major bleeding yielded a c‐statistic of 0.64. Conclusion The HA‐VTE IMRS and HA‐MB IMRS predict 90‐ and 30‐day VTE and major bleeding among COVID‐19 patients. Adding D‐dimer improved the predictiveness of the HA‐VTE IMRS for VTE.https://doi.org/10.1002/rth2.12765biomarkerbleedingrisk scorethrombosisvenous thromboembolism |
| spellingShingle | Scott C. Woller Scott M. Stevens Joseph R. Bledsoe Masarret Fazili James F. Lloyd Greg L. Snow Benjamin D. Horne Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 Research and Practice in Thrombosis and Haemostasis biomarker bleeding risk score thrombosis venous thromboembolism |
| title | Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 |
| title_full | Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 |
| title_fullStr | Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 |
| title_full_unstemmed | Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 |
| title_short | Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID‐19 |
| title_sort | biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with covid 19 |
| topic | biomarker bleeding risk score thrombosis venous thromboembolism |
| url | https://doi.org/10.1002/rth2.12765 |
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