Padua prediction score and IMPROVE score do predict in-hospital mortality in Internal Medicine patients
| Autor: | G. Arpaia, Giuseppe Marano, Claudio Cimminiello, Micaela Laregina, Patrizia Boracchi, Alessandro Caleffi, Francesco Orlandini, Giulia Erba |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty education 030204 cardiovascular system & hematology Validation Studies as Topic Likelihood ratios in diagnostic testing Risk Assessment Severity of Illness Index Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Internal Medicine Humans 030212 general & internal medicine Derivation Hospital Mortality health care economics and organizations Aged Retrospective Studies Prediction score In hospital mortality business.industry Reproducibility of Results Middle Aged Derivation cohort Clinical Practice Emergency Medicine Female business Risk assessment Venous thromboembolism |
| Zdroj: | Internal and emergency medicine. 15(6) |
| ISSN: | 1970-9366 |
| Popis: | Padua prediction score (PPS) and IMPROVE bleeding score are validated tools for venous thromboembolism (VTE) risk assessment recommended by guidelines, albeit not frequently used. Some data suggest that a positive PPS and IMPROVE score may be were associated with early mortality in Internal Medicine patients. Aim of the study was to characterize the predictive ability on mortality of the two scores using two different populations, respectively, as derivation and validation cohort. The derivation cohort consisted of 1956 Internal Medicine patients admitted to La Spezia Hospital in 2013. 399 Internal Medicine patients admitted to Carate Brianza Hospital in 2016 constituted the validation cohort. PPS and IMPROVE scores were applied to each patient using their validated cutoffs. Frequency of positive PPS and mortality were significantly higher in La Spezia patients. In the derivation cohort, the positivity of at least one of the two scores was associated with a significantly higher mortality compared to both negative scores. Similar results were observed in the validation cohort. In the derivation cohort, the sensitivity of a positive PPS score in predicting mortality was 0.97 (0.94, 0.98) but the specificity was 0.21 (0.19, 0.23), the negative likelihood ratio being 0.15. Sensitivity and specificity of a positive IMPROVE gave specular findings but the positive likelihood ratio was 2.19. The accuracy data in the validation cohort were in the same direction. Both PPS and IMPROVE are associated with in-hospital mortality but their additional predictive accuracy is modest. It is unlikely that both scores could be useful in clinical practice to predict death in hospitalized Internal Medicine patients. |
| Databáze: | OpenAIRE |
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