Luis Jara-Palomares1, Remedios Otero2, David Jimenez3, Marc Carrier4, Inna Tzoran5, Benjamin Brenner5, Mireia Margeli6, Juan Manuel Praena-Fernandez7, Elvira Grandone8, Manuel Monreal9. 1. Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Seville, Spain. Electronic address: luisoneumo@hotmail.com. 2. Medical Surgical Unit of Respiratory Diseases, Virgen del Rocio Hospital, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Seville, Spain. 3. Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Madrid, Spain. 4. Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada. 5. Thrombosis and Hemostasis Unit, Department of Hematology and Bone Marrow Transplantation Rambam Medical Center, Haifa, Israel. 6. Department of Medical Oncology, Hospital Universitari Germans Trias i Pujol de Badalona, Barcelona, Spain. 7. Statistics, Methodology and Research Evaluation Unit, Andalusian Public Foundation for Health Research Management, Hospital Virgen del Rocío, Seville, Spain. 8. Atherosclerosis and Thrombosis Unit, Casa Sollievo della Sofferenza, Foggia, Italy. 9. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol de Badalona, Barcelona, Universidad Católica de Murcia, Guadalupe, Spain.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Nick van Es; Grégoire Le Gal; Hans-Martin Otten; Philippe Robin; Andrea Piccioli; Ramon Lécumberri; Luis Jara-Palomares; Piotr Religa; Viriginie Rieu; Matthew T Rondina; Mariëlle M Beckers; Paolo Prandoni; Pierre-Yves Salaun; Marcello Di Nisio; Patrick M Bossuyt; Harry R Büller; Marc Carrier Journal: BMJ Open Date: 2017-06-10 Impact factor: 2.692
Authors: Luis Jara-Palomares; Remedios Otero; David Jimenez; Juan Manuel Praena-Fernandez; Carme Font; Conxita Falga; Silvia Soler; David Riesco; Peter Verhamme; Manuel Monreal Journal: PLoS One Date: 2018-03-20 Impact factor: 3.240
Authors: Rocío Figueroa; Ana Alfonso; José López-Picazo; Ignacio Gil-Bazo; Alberto García-Mouriz; José Hermida; José Antonio Páramo; Ramón Lecumberri Journal: PLoS One Date: 2018-08-02 Impact factor: 3.240