Portal de Periódicos da CAPES

Development of a Risk Prediction Score for Occult Cancer in Patients With VTE

2016; Elsevier BV; Volume: 151; Issue: 3 Linguagem: Inglês

10.1016/j.chest.2016.10.025

1931-3543

Luis Jara‐Palomares, Remedios Otero, David Jiménez, Marc Carrier, Inna Tzoran, Benjamin Brenner, Mireia Margelí Vila, Juan Manuel Praena‐Fernández, Elvira Grandone, Manuel Monréal, Manuel Monréal, Hervé Decousus, Paolo Prandoni, Benjamin Brenner, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Inna Tzoran, Abílio Reis, Marijan Bosevski, H Bounameaux, Radován Malý, Philip Wells, Manolis Papadakis, M.A. Aibar, Michael Alfonso, María Isabel Asensio-Cruz, Teresa Auguet, J.I. Arcelus, Raquel Barba, M. Barrón, B. Barrón‐Andrés, José Bascuñana, Á. Blanco-Molina, Tulio Bueso, I. Cañas, Andra Ceausu, N. Chic, Alex Culla, Roberto del Pozo, J. del Toro, Carmen Díaz‐Pedroche, J.A. Díaz-Peromingo, M. Duffort, Teresa Elías-Hernández, C. Falgá, C. Fernández‐Aracil, Carmen Fernández‐Capitán, M.A. Fidalgo, Carme Font, Llorenç Font, P. Gallego, M.A. García, F García‐Bragado, M. García-Rodenas, Vicente Gómez del Olmo, J. González, E Grau, A. Grimón, Ricardo Guijarro, L. Guirado, Juan Mata, G. Hernández-Comes, Luis Blasco, Elena Hernando-López, Luis Jara‐Palomares, M.J. Jaras, David Jiménez, M.D. Joya, Pilar Llamas, Ramón Lecumberri, J.L. Lobo, Luciano López-Jiménez, Raquel López-Reyes, J.B. López‐Sáez, M.A. Lorente, A. Lorenzo, Ana M. Maestre, P.J. Marchena, Maite Velázquez Martín, F. Martín‐Martos, Manuel Monréal, J.A. Nieto, Santiago Nieto, A. Núñez, M.J. Núñez, M. Odriozola, S. Otálora, Remedios Otero, Angel Manuel Hidalgo Ovejero, José María Pedrajas, Gustavo Pérez, C. Pérez‐Ductor, M.L. Peris, José Antonio Porras, Òscar Reig, A. Riera-Mestre, David Riesco, A. Rivas, M.A. Rodríguez‐Dávila, V. Rosa, Pedro Ruiz‐Artacho, N. Ruiz‐Giménez, J.C. Sahuquillo, M.C. Sala‐Sainz, A. Sampériz, Rosario Sánchez‐Martínez, O. Sanz, S. Soler, B. Sopeña, J.M. Suriñach, Carlos Tolosa, J. Trujillo-Santos, Fernando Uresandi, B. Valero, R. Valle, J. Vela, Purificación Vicente‐Galindo, G. Vidal, A. Villalobos, J Villalta, Thomas Vanassche, Peter Verhamme, Philip Wells, Jana Hirmerová, Radován Malý, E. Salgado, Laurent Bertoletti, A. Bura-Rivière, Dominique Farge, A. Hij, Isabelle Mahé, A. Merah, Farès Moustafa, Marios Papadakis, Andrei Braester, Benjamin Brenner, Inna Tzoran, G. Antonucci, Giovanni Barillari, A. Bertone, Franca Bilora, Cristiano Bortoluzzi, Maurizio Ciammaichella, C. Di Girolamo, Pierpaolo Di Micco, R. Duce, Paola Ferrazzi, Matteo Giorgi‐Pierfranceschi, Elvira Grandone, Corrado Lodigiani, R. Maida, Daniela Mastroiacovo, F. Pace, Raffaele Pesavento, Massimiliano Pinelli, Renzo Poggio, Paolo Prandoni, L. Rota, Eros Tiraferri, D. Tonello, Antonella Tufano, A. Visonà, Beniamino Zalunardo, E. Drucka, Dana Kigitoviča, Andris Skride, Mariana S. Sousa, Marijan Bosevski, Marija Zdraveska, H Bounameaux, Lucia Mazzolai,

Radiation Dose and Imaging

The benefits of a diagnostic workup for occult cancer in patients with VTE are controversial. Our aim was to provide and validate a risk score for occult cancer in patients with VTE.We designed a nested case-control study in a cohort of patients with VTE included in the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry from 2001 to 2014. Cases included cancer detected beyond the first 30 days and up to 24 months after VTE. Control subjects were defined as patients with VTE with no cancer in the same period.Of 5,863 eligible patients, 444 (7.6%; 95% CI, 6.8%-8.2%) were diagnosed with occult cancer. On multivariable analysis, variables selected were male sex, age > 70 years, chronic lung disease, anemia, elevated platelet count, prior VTE, and recent surgery. We built a risk score assigning points to each variable. Internal validity was confirmed using bootstrap analysis. The proportion of patients with cancer who scored ≤ 2 points was 5.8% (241 of 4,150) and that proportion in those who scored ≥ 3 points was 12% (203 of 1,713). We also identified scores divided by sex and age subgroups.This is the first risk score that has identified patients with VTE who are at increased risk for occult cancer. Our score needs to be externally validated.