Key result
A medium-high ICU-VTE score (9-18 points) was significantly associated with an increased risk of in-hospital venous thromboembolism compared to a low score (0-8 points) in critically ill tumor patients (OR 3.13).
Why the study?
Venous thromboembolism threatens the prognosis of tumor patients, particularly those who are critically ill, but no uniform standard VTE risk model existed for critically ill patients with tumors.
Can the ICU-VTE score and tumor grade predict in-hospital venous thromboembolism in critically ill patients with tumors?
Cohort (n=560)
No
Can the ICU-VTE score and tumor grade predict in-hospital venous thromboembolism in critically ill patients with tumors?
Odds Ratio: 3.13 (95% CI 2.01–4.85)
Absolute Event Rate: 62.5% vs 33.6%
p-value: p=<0.001
The ICU-VTE score, combined with tumor grade, can effectively predict the risk of in-hospital venous thromboembolism in critically ill patients with tumors.
Background Venous thromboembolism (VTE) is a threat to the prognosis of tumor patients, especially for critically ill patients. No uniform standard model of VTE risk for critically ill patients with tumors was formatted by now. We thus analyzed risk factors of VTE from the perspectives of patient, tumor and treatment, and assessed the predictive value of the ICU-VTE score, which consisted of six independent risk factors (central venous catheterization, 5 points; immobilization ≧ 4 days, 4 points; prior VTE, 4 points; mechanical ventilation, 2 points; lowest hemoglobin during hospitalization ≧ 90 g/L, 2 points; and baseline platelet count > 250 000/µL, 1 points). Methods We evaluated the data of tumor patients admitted to the Intensive Care Unit of the Peking University Cancer Hospital between November 2011 and January 2022, 560 cases who received VTE-related screening during hospitalization were chosen for this retrospective study. Results The in-hospital VTE occurrence rate in our cohort was 55.7% (312/560), with a median interval from ICU admission to VTE diagnosis of 8.0 days. After the multivariate logistic regression analysis, several factors were proved to be significantly associated with in-hospital VTE: age ≧ 65 yrs, high tumor grade (G3-4), medical diseases, fresh frozen plasma transfusion, and anticoagulant prophylaxis. The medium-high risk group according to the ICU-VTE score was positively correlated with VTE when compared with the low risk group (9–18 points vs. 0–8 points, OR, 3.13; 95% CI, 2.01–4.85, P < 0.001). The AUC of the ICU-VTE scores according to the ROC curve was 0.714 (95% CI, 0.67–0.75, P < 0.001). Conclusions The ICU-VTE score, as well as tumor grade, might assist in the assessment of in-hospital VTE risk for critically ill patients with tumors. The predictive accuracy might be improved when combining two of them, further follow-up researches are needed to confirm it.
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Mei et al. (2022) conducted a cohort in Critically ill patients with tumors (n=560). Medium-high risk ICU-VTE score (9-18 points) vs. Low risk ICU-VTE score (0-8 points) was evaluated on In-hospital VTE occurrence (OR 3.13, 95% CI 2.01-4.85, p=<0.001). A medium-high ICU-VTE score (9-18 points) was significantly associated with an increased risk of in-hospital venous thromboembolism compared to a low score (0-8 points) in critically ill tumor patients (OR 3.13).
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