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Thromb Haemost 2022; 122(07): 1177-1185
DOI: 10.1055/a-1693-0063
Stroke, Systemic or Venous Thromboembolism

Validation of Risk Assessment Models Predicting Venous Thromboembolism in Inpatients with Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Multicenter Cohort Study in China

Chen Zhou   *
1   West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Qun Yi   *
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Huiqing Ge
3   Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
,
Hailong Wei
4   Department of Respiratory and Critical Care Medicine, People's Hospital of Leshan, Leshan, Sichuan Province, China
,
Huiguo Liu
5   Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Jianchu Zhang
6   Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
,
Yuanming Luo
7   State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, China
,
Pinhua Pan
8   Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
,
Jiarui Zhang
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Lige Peng
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Adila Aili
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Yu Liu
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Maoyun Wang
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Yongjiang Tang
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Lan Wang
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Xia Zhong
1   West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Yixi Wang
1   West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
Haixia Zhou 
2   Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
,
On behalf of the MAGNET AECOPD Registry Investigators› Institutsangaben
Funding This study was supported by National Key Research Program of China (grant numbers: 2016yfc1304202 and 2016yfc1304200) and the National Natural Science Foundation of China (for young scholars, grant 81800016).
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Abstract

Background Inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at increased risk for venous thromboembolism (VTE); however, the prophylaxis for VTE is largely underused in China. Identifying high-risk patients requiring thromboprophylaxis is critical to reduce the mortality and morbidity associated with VTE. This study aimed to evaluate and compare the validities of the Padua Prediction Score and Caprini risk assessment model (RAM) in predicting the risk of VTE in inpatients with AECOPD in China.

Methods The inpatients with AECOPD were prospectively enrolled from seven medical centers of China between September 2017 and January 2020. Caprini and Padua scores were calculated on admission, and the incidence of 3-month VTE was investigated.

Results Among the 3,277 eligible patients with AECOPD, 128 patients (3.9%) developed VTE within 3 months after admission. The distribution of the study population by the Caprini risk level was as follows: high, 53.6%; moderate, 43.0%; and low, 3.5%. The incidence of VTE increased by risk level as high, 6.1%; moderate, 1.5%; and low, 0%. According to the Padua RAM, only 10.9% of the study population was classified as high risk and 89.1% as low risk, with the corresponding incidence of VTE of 7.9 and 3.4%, respectively. The Caprini RAM had higher area under curve compared with the Padua RAM (0.713 ± 0.021 vs. 0.644 ± 0.023, p = 0.029).

Conclusion The Caprini RAM was superior to the Padua RAM in predicting the risk of VTE in inpatients with AECOPD and might better guide thromboprophylaxis in these patients.

Keywords

acute exacerbation of chronic obstructive pulmonary disease - Caprini risk assessment model - inpatients - Padua Prediction Score - venous thromboembolism

Note

Haixia Zhou is the guarantor of the whole content of the manuscript. Chinese Clinical Trail Registry No.: ChiCTR2100044625; URL: http://www.chictr.org.cn/showproj.aspx?proj=121626.


Author Contributions

C.Z., Q.Y., and H.Z. contributed to the design of the study, the analysis and interpretation of data, and drafted the manuscript. All other authors contributed to acquisition and interpretation of data, and reviewed the manuscript. We appreciate the support and collaboration of the co-investigators participating in MAGNET AECOPD Registry study.


* Drs. Chen Zhou and Qun Yi contributed equally to this manuscript.


Supplementary Material



Publikationsverlauf

Eingereicht: 30. Mai 2021

Angenommen: 02. November 2021

Accepted Manuscript online:
10. November 2021

Artikel online veröffentlicht:
20. Januar 2022

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