Risk stratification for hospital-acquired venous thromboembolism in medical patients (RISE): Protocol for a prospective cohort study.

Autor: Choffat D; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Farhoumand PD; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland., Jaccard E; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., de la Harpe R; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Kraege V; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Benmachiche M; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Gerber C; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Leuzinger S; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland., Podmore C; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland., Truong MK; Division of Pneumology, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Dumans-Louis C; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland., Marti C; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland., Reny JL; Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland., Aujesky D; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Rakovic D; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Limacher A; CTU Bern, University of Bern, Bern, Switzerland., Rossel JB; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.; CTU Bern, University of Bern, Bern, Switzerland., Baumgartner C; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Méan M; Division of Internal Medicine, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 May 24; Vol. 17 (5), pp. e0268833. Date of Electronic Publication: 2022 May 24 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0268833
Abstrakt: Background: Hospital-acquired venous thromboembolism (VTE) is one of the leading preventable causes of in-hospital mortality. However, its risk assessment in medically ill inpatients is complicated due to the patients' heterogeneity and complexity of currently available risk assessment models (RAMs). The simplified Geneva score provides simplicity but has not yet been prospectively validated. Immobility is an important predictor for VTE in RAMs, but its definition is inconsistent and based on subjective assessment by nurses or physicians. In this study, we aim to prospectively validate the simplified Geneva score and to examine the predictive performance of a novel and objective definition of in-hospital immobilization using accelerometry.
Methods and Analysis: RISE is a multicenter prospective cohort study. The goal is to recruit 1350 adult inpatients admitted for medical illness in three Swiss tertiary care hospitals. We collect data on demographics, comorbidities, VTE risk and thromboprophylaxis. Mobility from admission to discharge is objectively measured using a wrist-worn accelerometer. Participants are followed for 90 days for the occurrence of symptomatic VTE (primary outcome). Secondary outcomes are the occurrence of clinically relevant bleeding, and mortality. The evolution of autonomy in the activities of daily living, the length of stay, and the occurrence of readmission are also recorded. Time-dependent area under the curve, sensitivity, specificity, and positive and negative predictive values are calculated for each RAM (i.e. the simplified and original Geneva score, Padua, and IMPROVE score) with and without the objective mobility measures to assess their accuracy in predicting hospital-acquired VTE at 90 days.
Ethics and Expected Impact: The ethics committee approved the protocol and the study was registered on ClinicalTrials.gov as NCT04439383. RISE has the potential to optimize VTE risk stratification, and thus to improve the quality of care of medically hospitalized patients.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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