Targeted prophylaxis for venous thromboembolism (VTE) using the Caprini risk score (CRS) is effective reducing postoperative VTE. Despite its availability as preventive strategy, risk scoring remains underutilized. Critics to the CRS contend the time it takes to complete, and its limitation to English language. Aim is to create and validate patient-completed CRS tools for Spanish, Arabic, and Polish speakers. We translated the first patient-completed CRS to Spanish, Arabic, and Polish. We conducted a pilot study followed by the validation study. Using PASS version 11, we determined that a sample size of 37 achieved a power of 80%, to detect a difference of 0.1 between the null hypothesis correlation of 0.5 and the alternative hypothesis correlation of 0.7 using a 2-sided hypothesis test, significance level of .05. We tabulated and categorized scores using SPSS version 23 to estimate k, linear correlation, and Bland Altman test. k value >0.8 was defined as "almost perfect agreement." From 129 recruited patients, 50 (39%) spoke Spanish, 40 (31%) spoke Arabic, and 39 (30%) spoke Polish; average age 51 (16.69) years, 58 (45%) were men, with less than college education (67%). Mean (standard deviation) CRS was 5 (3.90), the majority (63%) above moderate VTE risk. We report excellent agreement comparing physician and patient results (k ¼ 0.93) and high correlation 0.97 (P < .01) for the overall score. Bland Altman did not show trend for extreme values. We created and validated the first Spanish, Arabic, and Polish versions of the patient-completed CRS, with excellent correlation and agreement when compared to CRS-trained physician-completed form. Based on these results, the physician needs to calculate the body mass index. Completing the form was not time-consuming.
INTRODUCTION: Despite the decreased synthesis of coagulation factors and high bleeding risk in patients with cirrhosis, they are not free of venous thromboembolism (VTE) risk. The impact of VTE in patients with cirrhosis is not well understood, even less so the impact of acute VTE during hospitalization. This study set out to establish the impact of inpatient VTE occurrence in mortality, bleeding, length and cost of hospitalization in patients with cirrhosis. METHODS: We identified individuals ≥ 18 years old from the 2003-2014 National Inpatient Sample database with a diagnosis of cirrhosis using ICD-9-CM codes. Cirrhosis, acute deep vein thrombosis of extremities and acute pulmonary embolism diagnoses were allocated if present among the top 10 admission diagnoses. Demographics and inpatient outcomes of patients with VTE were compared to those without VTE. We used SPSS 25 to calculated odds ratios (OR) with confidence intervals (CI), and trend analysis. RESULTS: A total of 1,165,369 cirrhotic patients were included (weighted cases = 5,594,565). 11,049 (0.9%) VTE cases were diagnosed. Patients with VTE were older (61.9 vs 58.4 years, P < 0.0001), and less likely females (36.8% vs 39%, P < 0.0001). Patients with VTE were more likely to die during the hospitalization (OR 1.6 [CI 95% 1.5-1.71, P < 0.0001]), to have intracranial bleeding (OR 1.3 [CI 95% 1.03–1.64, P = 0.02]), retroperitoneal bleeding (OR 2.36 [CI 95% 1.68–3.3, P < 0.0001]), had longer inpatient stay (9.6 vs 6.0 days, P < 0.0001), and higher costs (72,434 vs 41,670 USD, P < 0.0001). There was an increasing trend of inpatient VTE per year (0.27% 2003 vs 1.16% 2014, P < 0.0001) but a decreasing trend in inpatient mortality per year in cirrhotic patients with VTE (17.6% 2003 vs 9.2% 2014, P = 0.0001). CONCLUSION: VTE occurrence is associated with increased inpatient mortality, intracranial bleed, retroperitoneal bleed, length and cost of hospitalization. More thorough VTE prophylaxis strategies may need to be implemented in patients with cirrhosis.
Venous thromboembolism (VTE) and coronary artery disease are major health issues that cause substantial morbidity and mortality. New data have emerged suggesting that these two conditions could have a close relationship. Thus, we sought to determine the trends in annual rate of VTE occurrence in patients with ST-segment elevation myocardial infarction (STEMI) and measure its impact on in-hospital mortality, bleeding complications, and cost and length of hospitalization. We queried the 2003–2013 Nationwide Inpatient Sample databases to identify adults with primary diagnosis of STEMI. VTE events were then allocated. Inpatient outcomes of patients with VTE were compared to those without VTE. Out of 2,495,757 hospitalizations for STEMI, VTE was diagnosed in 25,149 (1%) hospitalizations. Patients who experienced VTE were older (mean age: 67.5 vs 64.8, p < 0.01) and had a higher proportion of black patients (10.1% vs 7.7%, p < 0.001) and females (40.1% vs 35%, p < 0.001) compared to patients without VTE. There was an increasing trend in the rate of VTE during the study period (2003: 0.8% vs 2013: 1.0%, p < 0.001). Patients with VTE had a prolonged hospitalization (median: 9 vs 3 days, p < 0.001), increased cost, higher risk of gastrointestinal bleeding (OR: 2.13, p < 0.001), intracranial hemorrhage (OR: 2.14, p < 0.001), blood transfusions (OR: 1.94, p < 0.001), and mortality (OR: 1.39, p < 0.001). The rate of VTE occurrence in patients with STEMI in our study was 10 per 1000 admissions. VTE was associated with more bleeding complications, longer hospital stays, higher costs, and mortality. These findings suggest that a more aggressive approach for VTE prophylaxis may be warranted in this population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.