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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Development and validation of a risk model for hospital-acquired venous thrombosis: the Medical Inpatients Thrombosis and Hemostasis study
Journal of thrombosis and haemostasis, v 22(2), pp 503-515
01 Feb 2024
PMID: 37918635
Abstract
BACKGROUND
Regulatory organizations recommend assessing hospital-acquired (HA) venous thromboembolism (VTE) risk for medical inpatients.
OBJECTIVES
To develop and validate a risk assessment model (RAM) for HA-VTE in medical inpatients using objective and assessable risk factors knowable at admission.
METHODS
The development cohort included people admitted to medical services at the University of Vermont Medical Center (Burlington, Vermont) between 2010 and 2019, and the validation cohorts included people admitted to Hennepin County Medical Center (Minneapolis, Minnesota), University of Michigan Medical Center (Ann Arbor, Michigan), and Harris Health Systems (Houston, Texas). Individuals with VTE at admission, aged <18 years, and admitted for <1 midnight were excluded. We used a Bayesian penalized regression technique to select candidate HA-VTE risk factors for final inclusion in the RAM.
RESULTS
The development cohort included 60 633 admissions and 227 HA-VTE, and the validation cohorts included 111 269 admissions and 651 HA-VTE. Seven HA-VTE risk factors with t statistics ≥1.5 were included in the RAM: history of VTE, low hemoglobin level, elevated creatinine level, active cancer, hyponatremia, increased red cell distribution width, and malnutrition. The areas under the receiver operating characteristic curve and calibration slope were 0.72 and 1.10, respectively. The areas under the receiver operating characteristic curve and calibration slope were 0.70 and 0.93 at Hennepin County Medical Center, 0.70 and 0.87 at the University of Michigan Medical Center, and 0.71 and 1.00 at Harris Health Systems, respectively. The RAM performed well stratified by age, sex, and race.
CONCLUSION
We developed and validated a RAM for HA-VTE in medical inpatients. By quantifying risk, clinicians can determine the potential benefits of measures to reduce HA-VTE.
Metrics
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10 citations in Scopus
Details
- Title
- Development and validation of a risk model for hospital-acquired venous thrombosis: the Medical Inpatients Thrombosis and Hemostasis study
- Creators
- Neil A Zakai - University of VermontKatherine Wilkinson - University of VermontAndrew D Sparks - University of VermontRyan T PackerInsu Koh - University of VermontNicholas S Roetker - Hennepin Healthcare Research InstituteAllen B Repp - University of VermontRyan Thomas - University of VermontChris E Holmes - University of VermontMary Cushman - University of VermontTimothy B Plante - University of VermontHanny Al-SamkariAllyson M Pishko - University of PennsylvaniaWilliam A Wood - University of North Carolina at Chapel HillCamila Masias - Baptist Hospital of MiamiRadhika Gangaraju - University of Alabama at BirminghamAng Li - Baylor College of MedicineDavid Garcia - University of WashingtonKerri L Wiggins - University of WashingtonJordan K Schaefer - University of MichiganCraig Hooper - Centers for Disease Control and PreventionNicholas L Smith - University of WashingtonLeslie A McClure - Drexel University
- Publication Details
- Journal of thrombosis and haemostasis, v 22(2), pp 503-515
- Publisher
- Elsevier
- Number of pages
- 13
- Grant note
- National Heart, Lung, and Blood Institute, National Institutes of Health (https://doi.org/10.13039/100000050) Centers for Disease Control and Prevention (https://doi.org/10.13039/100000030) Cancer Prevention and Research Institute of Texas (https://doi.org/10.13039/100004917)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Scopus ID
- 2-s2.0-85178246614
- Other Identifier
- 991021811736104721