A local risk score model for venous thromboembolism prophylaxis for caesarean section in Chinese women and comparison with international guidelines

Lok, Wing Yi; Kong, Choi Wah; To, William W. K.

doi:10.1016/j.tjog.2019.05.016

Cited by 8 publications

(22 citation statements)

References 27 publications

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“…Only one of these studies35 presented data on model development and external validation (this study used UK Clinical Practice Research Data linked to Hospital Episode Statistics to develop a risk prediction model and externally validated using Swedish medical birth registry data). The remaining studies focused on external validation with no description of the initial derivation methodology 23–34 36–38. Due to the lack of model derivation studies with external validation, we also identified and included one internal validation study for completeness (ie, prediction model development without external validation) 39.…”

Section: Resultsmentioning

confidence: 99%

“…The design and participant characteristics of the 17 included studies are summarised in table 1. All studies were published between 2000 and 2020 and were undertaken in North America (n=4),24 37–39 Southeast Asia (n=1),33 Europe (n=10),23 25–30 32 34 36 South America (n=1)31 and one study was multicountry 35. Sample sizes ranged from 5231 to 662 38735 patients in 14 observational cohort studies (6 prospective25 27 28 31 33 36 (all single centre) and 8 retrospective24 26 29 30 34 35 37 39 [2 of which were multicentre] in design).…”

Section: Resultsmentioning

confidence: 99%

“…Figure 1 summarises the process of identifying and selecting relevant literature. Of the 2268 citations identified, 16 studies [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] investigating 19 unique externally validated RAMs met the inclusion criteria. Only one of these studies 35 presented data on model development and external validation (this study used UK Clinical Practice Research Data linked to Hospital Episode Statistics to develop a risk prediction model and externally validated using Swedish medical birth registry data).…”

Section: Study Flowmentioning

confidence: 99%

“…The studies included in this review evaluated 19 externally validated RAMs [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] and 1 internally validated risk model. 39 While most RAMs focused solely on the estimate of thromboembolic risk, RAMs varied in design, structure, threshold, dosage and duration for pharmacological prophylaxis.…”

Section: Ramsmentioning

confidence: 99%

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Risk assessment models for venous thromboembolism in pregnancy and in the puerperium: a systematic review

et al. 2022

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ObjectivesTo assess the comparative accuracy of risk assessment models (RAMs) to identify women during pregnancy and the early postnatal period who are at increased risk of venous thromboembolism (VTE).DesignSystematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMEDLINE, Embase, Cochrane Library and two research registers were searched until February 2021.Eligibility criteriaAll validation studies that examined the accuracy of a multivariable RAM (or scoring system) for predicting the risk of developing VTE in women who are pregnant or in the puerperium (within 6 weeks post-delivery).Data extraction and synthesisTwo authors independently selected and extracted data. Risk of bias was appraised using PROBAST (Prediction model Risk Of Bias ASsessment Tool). Data were synthesised without meta-analysis.ResultsSeventeen studies, comprising 19 externally validated RAMs and 1 internally validated model, met the inclusion criteria. The most widely evaluated RAMs were the Royal College of Obstetricians and Gynaecologists guidelines (six studies), American College of Obstetricians and Gynecologists guidelines (two studies), Swedish Society of Obstetrics and Gynecology guidelines (two studies) and the Lyon score (two studies). In general, estimates of sensitivity and specificity were highly variable with sensitivity estimates ranging from 0% to 100% for RAMs that were applied to antepartum women to predict antepartum or postpartum VTE and 0% to 100% for RAMs applied postpartum to predict postpartum VTE. Specificity estimates were similarly diverse ranging from 28% to 98% and 5% to 100%, respectively.ConclusionsAvailable data suggest that external validation studies have weak designs and limited generalisability, so estimates of prognostic accuracy are very uncertain.PROSPERO registration numberCRD42020221094.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Flowmentioning

confidence: 99%

Section: Ramsmentioning

confidence: 99%

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Risk assessment models for venous thromboembolism in pregnancy and in the puerperium: a systematic review

et al. 2022

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“…Se encontró un índice de kappa de 0,47 (IC 95 %: 0,38-0,56). Más allá del estudio antes mencionado de Pomerola at al (9) y de Lok et al (11) que comparo una escala desarrollada de China con la escala del RCOG y del ACOG, estudios que muestran diferencias muy amplias en la calificación del riesgo, no se identifican estudios que hayan evaluado el grado de concordancia entre las diferentes escalas disponibles para calificar el riesgo de enfermedad tromboembólica en el embarazo. Por otra parte, dada la naturaleza local de la guía colombiana para tromboprofilaxis en el embarazo, no se identificaron estudios que hubieran evaluado esta herramienta previamente en este aspecto.…”

Section: Discussionunclassified

Concordancia entre dos escalas para evaluar la clasificación del riesgo de eventos tromboembólicos y el requerimiento de profilaxis farmacológica en el posparto

Silva-Herrera¹,

Polanía-Reyes²,

Aya-Porto³

et al. 2022

Rev. Colomb. Obstet. Ginecol.

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Objetivos: establecer la concordancia para evaluar el requerimiento de profilaxis farmacológica en el puerperio entre la escala del Royal College Obstetricians and Gynaecologists y la escala de la guía colombiana en una institución de cuarto nivel en Bogotá, Colombia.Materiales y métodos: estudio de concordancia diagnóstica ensamblado sobre un estudio transversal. Se incluyeron mujeres embarazadas con 24 o más semanas de gestación que ingresaron para inducción de trabajo de parto, en trabajo de parto activo, para cesárea electiva, o que requirieron cesárea de urgencia, hospitalizadas entre el 1 de marzo y 30 de abril de 2021 en una institución privada de alta complejidad en Bogotá, Colombia. Se realizó un muestreo por conveniencia. Se midieron variables demográficas, factores de riesgo, clasificación del riesgo y profilaxis farmacológica según las dos escalas. Se calculó la prevalencia de los factores de riesgo por cada escala y la concordancia en la indicación de la profilaxis entre las dos escalas por medio del valor de kappa ponderado.Resultados: se incluyeron 320 pacientes. La escala del Royal College Obstetricians and Gynaecologists clasificó al 54,7 % de las pacientes en riesgo bajo, riesgo intermedio al 42,5 % y riesgo alto al 2,8%. La escala colombiana clasificó al 80 % de las pacientes en riesgo bajo, 17,2 % riesgo intermedio, 2,2 % riesgo alto y 0,6 % con riesgo muy alto. El valor kappa ponderado para la concordancia para indicación fue de 0,47 (IC 95 %: 0,38-0,56).Conclusiones: la concordancia de las dos escalas para definir requerimiento de profilaxis farmacológica en el posparto tiene un acuerdo moderado. Se considera es necesario validar los criterios de clasificación del riesgo de la escala colombiana en una segunda cohorte, además evaluar la capacidad predictiva de la herramienta de la guía colombiana en diferentes puntos de corte en términos de las consecuencias de falsos positivos y negativos.

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Guideline-based venous thromboprophylaxis in postpartum women: An in-depth evaluation of ACOG and RCOG recommendations and real-life implementation

Kayikci,

Fadiloglu,

Cigdem Bayrak

et al. 2024

European Journal of Obstetrics & Gynecology and Reproductiv

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A local risk score model for venous thromboembolism prophylaxis for caesarean section in Chinese women and comparison with international guidelines

Cited by 8 publications

References 27 publications

Risk assessment models for venous thromboembolism in pregnancy and in the puerperium: a systematic review

Risk assessment models for venous thromboembolism in pregnancy and in the puerperium: a systematic review

Concordancia entre dos escalas para evaluar la clasificación del riesgo de eventos tromboembólicos y el requerimiento de profilaxis farmacológica en el posparto

Guideline-based venous thromboprophylaxis in postpartum women: An in-depth evaluation of ACOG and RCOG recommendations and real-life implementation

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