Predicting venous thromboembolism in multiple myeloma: development and validation of the IMPEDE VTE score
| Autor: | Martin W. Schoen, Mark A. Fiala, Suhong Luo, David C. Calverley, Kenneth R. Carson, Nicole M. Kuderer, Tzu-Fei Wang, Jesse Keller, Kristen M. Sanfilippo, Tanya M. Wildes, Theodore S. Thomas, Joseph Mikhael, Brian F. Gage |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty Vena Cava Filters Databases Factual medicine.medical_treatment Comorbidity Medicare Risk Assessment Dexamethasone Article Body Mass Index Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols Epidemiology medicine Humans cardiovascular diseases Aged Retrospective Studies Femur fracture Framingham Risk Score business.industry Hazard ratio Hematopoietic Stem Cell Transplantation Anticoagulants Retrospective cohort study Venous Thromboembolism Hematology Middle Aged equipment and supplies Combined Modality Therapy United States Cancer registry Cohort Female Multiple Myeloma business Central venous catheter Follow-Up Studies Glomerular Filtration Rate SEER Program |
| Zdroj: | Am J Hematol |
| ISSN: | 1096-8652 0361-8609 |
| Popis: | BACKGROUND: Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with multiple myeloma (MM). The International Myeloma Working Group (IMWG) developed guidelines recommending primary thromboprophylaxis in those identified at high-risk of VTE by the presence of risk factors. The National Comprehensive Cancer Network (NCCN) has adopted these guidelines; however, they lack validation. We sought to develop and validate a risk prediction score for VTE in MM and to evaluate the performance of the current IMWG/NCCN guidelines. METHODS: Using 4,446 patients within the Veterans Administration Central Cancer Registry, we used time-to-event analyses to develop a risk score for VTE in patients with newly diagnosed MM starting chemotherapy. We externally validated the score using the Surveillance, Epidemiology, End Results (SEER)-Medicare database (N = 4,256). RESULTS: After identifying independent predictors of VTE, we combined the variables to develop the IMPEDE VTE score (Immunomodulatory agent; Body Mass Index ≥ 25 kg/m(2); Pelvic, hip or femur fracture; Erythropoietin stimulating agent; Dexamethasone/Doxorubicin; Asian Ethnicity/Race; VTE history; Tunneled line/central venous catheter; Existing thromboprophylaxis). The score showed satisfactory discrimination in the derivation cohort, c-statistic = 0.66. Risk of VTE significantly increased as score increased (hazard ratio 1.20, p = |
| Databáze: | OpenAIRE |
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