The Frankfurt AMBOS score, incorporating age, sex, neurooncological disease, blood type, and Marcumar therapy, successfully stratified pulmonary embolism risk in neurocritical care patients, with incidence ranging from 0% for 0-1 points to 70% for 6 points.
Observational (n=387)
No
The Frankfurt AMBOS score, incorporating age, sex, oncological disease, blood type, and Marcumar therapy, provides a novel risk stratification tool for pulmonary embolism in neurocritical care patients.
Pulmonary embolism (PE) due to deep vein thrombosis is a complication with severe morbidity and mortality rates. Neurocritical care patients constitute an inhomogeneous cohort with often strict contraindications to conventional embolism treatment. The aim of the present study is to identify risk factors for pulmonary embolism for intensified risk stratification in this demanding cohort. In this retrospective analysis, 387 neurocritical care patients received computed tomography for clinical suspicion of PE (304 neurosurgical and 83 neurological patients). Analysed parameters included age, gender, disease pattern, the presence of deep vein thrombosis, resuscitation, in-hospital mortality, present anticoagulation, coronary artery disease, diabetes mellitus, smoking status, hypertension and ABO blood type. Computed tomography confirmed 165 cases of pulmonary embolism among 387 patients with clinical suspicion of pulmonary embolism (42%). Younger age (p < 0.0001), female gender (p < 0.006), neurooncological disease (p < 0.002), non-O blood type (p < 0.002) and the absence of Marcumar therapy (p < 0.003) were identified as significant risk factors for pulmonary embolism. On the basis of the identified risk factors, the AMBOS score system is introduced. Neurocritical care patients with high AMBOS score are at elevated risk for PE and should therefore be put under intensified monitoring for cardiovascular events in neurocritical care units.
Dubinski et al. (Tue,) conducted a observational in Clinical suspicion of pulmonary embolism in neurocritical care (n=387). Frankfurt AMBOS score risk factors (age, sex, neurooncological disease, blood type, Marcumar therapy) vs. Patients without these risk factors / lower AMBOS scores was evaluated on Computed tomography confirmed pulmonary embolism. The Frankfurt AMBOS score, incorporating age, sex, neurooncological disease, blood type, and Marcumar therapy, successfully stratified pulmonary embolism risk in neurocritical care patients, with incidence ranging from 0% for 0-1 points to 70% for 6 points.