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Thromb Haemost 2023; 123(07): 692-699
DOI: 10.1055/a-2039-3388
New Technologies, Diagnostic Tools and Drugs

Performance and Head-to-Head Comparison of Three Clinical Models to Predict Occurrence of Postthrombotic Syndrome: A Validation Study

Michelle Pradier
1   Department of Medicine (Division of Hematology) and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
2   Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
,
Marc A. Rodger
3   Department of Medicine, Faculty of Medicine, McGill University, Montréal, Quebec, Canada
,
Waleed Ghanima
4   Department of Research, Ostfold Hospital Trust, Norway
5   Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
,
Michael J. Kovacs
6   Division of Hematology, Department of Medicine, University of Western Ontario, London, Ontario, Canada
,
Sudeep Shivakumar
7   Division of Hematology, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
,
Susan R. Kahn
8   Department of Medicine, McGill University and Division of Clinical Epidemiology, Lady Davis Institute, Montreal, Quebec, Canada
,
Per Morten Sandset 
9   Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
,
Clive Kearon   *
1   Department of Medicine (Division of Hematology) and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
10   Department of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Ranjeeta Mallick
11   The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
,
Aurélien Delluc 
1   Department of Medicine (Division of Hematology) and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
2   Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
› Author Affiliations Funding This study was funded by the Canadian Institutes of Health Research (CIHR # PJT 148716) and the Southern and Eastern Norway Regional Health Authority (Grant # 2015112).
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Abstract

Objective The SOX-PTS, Amin, and Méan models are three different clinical prediction scores stratifying the risk for postthrombotic syndrome (PTS) development in patients with acute deep vein thrombosis (DVT) of the lower limbs. Herein, we aimed to assess and compare these scores in the same cohort of patients.

Methods We retrospectively applied the three scores in a cohort of 181 patients (196 limbs) who participated in the SAVER pilot trial for an acute DVT. Patients were stratified into PTS risk groups using positivity thresholds for high-risk patients as proposed in the derivation studies. All patients were assessed for PTS 6 months after index DVT using the Villalta scale. We calculated the predictive accuracy for PTS and area under receiver operating characteristic (AUROC) curve for each model.

Results The Méan model was the most sensitive (sensitivity 87.7%; 95% confidence interval [CI]: 77.2–94.5) with the highest negative predictive value (87.5%; 95% CI: 76.8–94.4) for PTS. The SOX-PTS was the most specific score (specificity 97.5%; 95% CI: 92.7–99.5) with the highest positive predictive value (72.7%; 95% CI: 39.0–94.0). The SOX-PTS and Méan models performed well for PTS prediction (AUROC: 0.72; 95% CI: 0.65–0.80 and 0.74; 95% CI: 0.67–0.82), whereas the Amin model did not (AUROC: 0.58; 95% CI: 0.49–0.67).

Conclusion Our data support that the SOX-PTS and Méan models have good accuracy to stratify the risk for PTS.

Keywords

deep vein thrombosis - postthrombotic syndrome - prediction rules

* Deceased


Supplementary Material



Publication History

Received: 22 November 2022

Accepted: 17 February 2023

Accepted Manuscript online:
21 February 2023

Article published online:
24 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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