Key result
PANWARDS score ≥25 predicts major intracranial hemorrhage with 100% sensitivity in glioma patients on enoxaparin.
Observational
Effect estimate: Sensitivity 100% (95% CI 63% to 100%)
p-value: p=0.012
= .012). We applied a validated ICH prediction risk score PANWARDS (platelets, albumin, no congestive heart failure, warfarin, age, race, diastolic blood pressure, stroke), and observed that all major ICHs on enoxaparin occurred in the setting of a PANWARDS score ≥25, corresponding with a sensitivity of 100% (95% CI, 63% to 100%) and a specificity of 40% (95% CI, 25% to 56%). We conclude that caution is warranted when considering therapeutic anticoagulation in patients with high-grade gliomas given the increased risk of ICH and poor prognosis after a major hemorrhage on anticoagulation. The PANWARDS score may assist clinicians in identifying the patients at greatest risk of suffering a major intracranial hemorrhage with anticoagulation.
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Mantia et al. (2017) conducted an observational in High-grade gliomas. PANWARDS score ≥25 vs. PANWARDS score <25 was evaluated on Major intracranial hemorrhage (Sensitivity 100%, 95% CI 63% to 100%, p=0.012). In glioma patients receiving therapeutic enoxaparin, a PANWARDS score ≥25 predicted all major intracranial hemorrhages with 100% sensitivity (95% CI 63-100%) and 40% specificity (95% CI 25-56%).
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