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Trabulsi N, Khafagy AM, Alhazmi LS, Alghamdi AM, Alzahrani AA, Banaamah MM, Farsi A, Shabkah A, Samkari A, Al-Hajeili M, Abduljabbar A, Wazzan M. Caprini versus Padua venous thromboembolism risk assessment scores: A comparative study in hospitalized patients at a tertiary center. Saudi Med J 2024; 45:362-368. [PMID: 38657986 PMCID: PMC11147578 DOI: 10.15537/smj.2024.45.4.20230954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/16/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES To assess and compare the Caprini and Padua risk assessment models (RAMs) for predicting venous thromboembolism (VTE) in hospitalized patients. METHODS We retrospectively reviewed 28 VTE and 450 non-VTE patients hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, in 2019. Their baseline medical, demographic, and radiological reports were recorded. We compared Caprini scores (defined at admission) and Padua scores (calculated retrospectively) for their ability to predict VTE. A cumulative risk score was created by adding the individual scores for each risk factor. We also analyzed the sensitivity, specificity, and diagnostic accuracy of the RAM scores. RESULTS Major differences in risk factors were shown between patients with and without VTE. Previous VTE was significantly associated with a higher risk of VTE (28.6%), as was reduced mobility (57.1%), acute infection (25%), high Caprini score (50%), and high Padua score (64.3%, p<0.05). The sensitivity of the Caprini score (96%) was higher than that of the Padua score (64.3%), as was the specificity (92.1% vs. 46.9%), positive predictive value (93% vs. 7%), and accuracy (94.1% vs. 47.9%). The specificity of the Caprini score was higher than that of the Padua score in Critical Care, Gynecology/Obstetrics, and Surgical departments. The Caprini RAM showed the lowest level of specificity in the medical department. CONCLUSION The Caprini RAM demonstrated higher sensitivity, specificity, and predictive accuracy than did the Padua RAM and thus distinguished low and high VTE risk in hospitalized patients.
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Affiliation(s)
- Nora Trabulsi
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Abdulmajeed M. Khafagy
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Lenah S. Alhazmi
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Abdullah M. Alghamdi
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Abdulmajeed A. Alzahrani
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Mohanned M. Banaamah
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Ali Farsi
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Alaa Shabkah
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Ali Samkari
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Marwan Al-Hajeili
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Ahmed Abduljabbar
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
| | - Mohammad Wazzan
- From the Department of Surgery (Trabulsi, Alhazmi, Alzahrani, Samkari, Farsi); from the Department of Internal Medicine (Khafagy, Al-Hajeili); from the Department of Radiology (Banaamah, Abduljabbar, Wazzan), Faculty of Medicine, King Abdulaziz University, from the Department of Internal Medicine (Alghamdi), King Abdulaziz University Hospital, and from the Department of Surgery (Shabkah), International Medical Center, Jeddah, Kingdom of Saudi Arabia.
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Chen X, Huang J, Liu J, Chang J, Pan L, Wang Y, Gao Y, Yang Y. Derivation and External Validation of a Risk Assessment Model of Venous Thromboembolism in Hospitalized Chinese Patients. Clin Appl Thromb Hemost 2023; 29:10760296221151164. [PMID: 36650933 PMCID: PMC9869208 DOI: 10.1177/10760296221151164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
AIM To develop and validate a risk assessment model (RAM) of venous thromboembolism (VTE) in hospitalized Chinese patients. METHODS We reviewed data from 300 patients with VTE and 300 non-VTE patients at Beijing Shijitan Hospital. The risk factors related to VTE were analyzed, and the VTE RAM (Shijitan (SJT) version) was developed according to the weight of each risk factor. A total of 407 patients with VTE and 533 non-VTE patients were enrolled for external validation. The sensitivity, specificity, Youden index, receiver operating curve (ROC), and area under the ROC curve (AUC) were used to evaluate the performance of VTE RAM (SJT version) compared with Caprini RAM and Padua RAM. RESULTS The VTE RAM (SJT version) contained six risk factors (age >60 years, lower limb edema, chronic obstructive pulmonary disease (COPD), central venous catheterization (CVC), VTE history, and D dimer). In the external validation group, for medical patients, the AUC value of SJT RAM (0.82 ± 0.03) is significantly higher than Caprini RAM (0.76 ± 0.04; P < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Caprini RAM (P < 0.05), which means that the SJT RAM has a much better predictive value than Caprini RAM. While SJT RAM and Padua RAM have the similar predictive value for medical patients (P > 0.05). For surgical patients, the AUC value of SJT RAM (0.72 ± 0.04) is significantly higher than the value of Padua RAM (0.66 ± 0.04; P < 0.05), SJT RAM has a higher sensitivity, specificity, and Youden index than Padua RAM (P < 0.05), which shows that the VTE RAM has better predictive value than Padua RAM. While SJT RAM and Caprini RAM have the similar predictive value for surgical patients (P > 0.05). CONCLUSION The SJT RAM derived from general hospitalized Chinese patients will be time-saving for physicians and has a better predictive ability for patients at risk of VTE.
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Affiliation(s)
- Xiaolan Chen
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jiali Huang
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jinxuan Liu
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jiaqi Chang
- School of Statistics and Data Science, Nankai University, Tianjin, China,Yuanhua Yang, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
| | - Lei Pan
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China,Lei Pan, Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
| | - Yong Wang
- Beijing Emergency Medical Center, Beijing, China
| | - Yuan Gao
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yuanhua Yang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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