Key result
Elevated serum homocysteine levels (OR 5.17) and higher Wells scores (OR 5.26) were independently associated with an increased risk of developing venous thromboembolism in patients with AECOPD.
Why the study?
The study aimed to evaluate the diagnostic value of homocysteine levels combined with the Wells score and establish a prediction model for venous thromboembolism occurrence in patients with AECOPD.
Does a prediction model based on serum homocysteine levels and Wells score accurately predict the occurrence of venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease?
Cohort (n=914)
No
Does a prediction model based on serum homocysteine levels and Wells score accurately predict the occurrence of venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease?
Answers are grounded in this paper and cite their sources.
A prediction model combining serum homocysteine levels, Wells score, and clinical parameters accurately predicts the risk of venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease.
BACKGROUND: We evaluated the diagnostic value of homocysteine (Hcy) levels combined with the Wells score and established a prediction model for venous thromboembolism (VTE) occurrence in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) based on the Hcy level and the Wells score. PATIENTS AND METHODS: Clinical information from 914 patients with AECOPD was retrospectively collected in our hospital from June 2020 to October 2023. Receiver operating characteristic curves were plotted to evaluate the diagnostic ability of Hcy concentrations combined with Wells scores and the prediction ability of the model. Univariate and multivariate logistic regressions were used to explore the effects of Hcy levels and the Wells score on VTE occurrence. A nomogram was established for individual risk evaluation. RESULTS: Hcy levels and Wells scores were significantly greater in the VTE group than in the non-VTE group (P < 0.001). The diagnostic ability of Hcy levels combined with the Wells score was greater than that Hcy levels or the Wells score alone. The AUC of the combined parameters was 0.935, with a sensitivity of 0.864 and a specificity of 0.855. Multivariate logistic regression indicated that elevated Hcy levels (OR:5.17, 95%CI: 3.76-7.09, P < 0.001) and Wells score (OR: 5.26, 95%CI: 3.22-8.59, P < 0.001) were independently associated with the risk of developing VTE in AECOPD patients. Decision curve analysis indicated that the net benefit of the nonadherence prediction nomogram was greater than that of the models adjusted for no or all variables, with a threshold of approximately 0.1-1.0. CONCLUSIONS: The established prediction model can be used to evaluate an individual's risk of developing VTE on the basis of the Hcy level, Wells score, and clinical parameters. AECOPD patients may benefit from the early intervention based on estimated risk probability.
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Liu et al. (2024) conducted a cohort in Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n=914). Elevated homocysteine (Hcy) levels vs. Lower homocysteine (Hcy) levels was evaluated on Occurrence of venous thromboembolism (VTE) (OR 5.17, 95% CI 3.76-7.09, p=<0.001). Elevated serum homocysteine levels (OR 5.17) and higher Wells scores (OR 5.26) were independently associated with an increased risk of developing venous thromboembolism in patients with AECOPD.
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