Validation of Risk Assessment Models Predicting Venous Thromboembolism in Inpatients with Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Multicenter Cohort Study in China

Abstract

Background: As inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at increased risk for venous thromboembolism (VTE), identifying high-risk patients requiring thromboprophylaxis is critical to reduce the mortality and morbidity associated with VTE. This study aimed to evaluate and compare the validities of the Padua Prediction Score and Caprini risk assessment model (RAM) in predicting the risk of VTE in inpatients with AECOPD. Methods: The inpatients with AECOPD were prospectively enrolled from seven medical centers of China between September 2017 and January 2020. Caprini and Padua scores were calculated on admission, and the incidence of 3-month VTE was investigated. Results: Among the 3277 eligible patients with AECOPD, 128 patients (3.9%) developed VTE within 3 months after admission. The distribution of the study population by the Caprini risk level was as follows: high, 53.6%; moderate, 43.0%; and low, 3.5%. The incidence of VTE increased by risk level as high, 6.1%; moderate, 1.5%; and low, 0%. According to the Padua RAM, only 10.9% of the study population was classified as high risk and 89.1% as low risk, with the corresponding incidence of VTE 7.9% and 3.4%, respectively. The Caprini RAM had higher area under curve (AUC) compared with the Padua RAM (0.713  0.021 vs 0.644 ± 0.023, P = 0.029). Conclusion: The Caprini RAM was superior to the Padua RAM in predicting the risk of VTE in inpatients with AECOPD and might better guide thromboprophylaxis in these patients.

Risk factors of in-hospital mortality and discriminating capacity of NIVO score in exacerbations of COPD requiring noninvasive ventilation

“…The research results of the MAGNET AECOPD Registry study have been published previously. 14 – 17 In the present study, inclusion criteria: (1) AECOPD as primary diagnosis; (2) pre-admission spirometry evidence of airflow obstruction (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 0.7); (3) acute hypercapnic respiratory failure (pH < 7.35 or partial pressure of carbon dioxide (PaCO2) > 45 mmHg) treated with assisted NIV. Exclusion criteria were patients without acute hypercapnic respiratory failure and data missed.…”

Characteristics, treatments, in-hospital and long-term outcomes among inpatients with acute exacerbation of chronic obstructive pulmonary disease in China: sex differences in a large cohort study

“…The major aims of the MAGNET AECOPD study were to investigate the characteristics, treatments and adverse outcomes (including intensive treatments usage; in-hospital venous thromboembolism (VTE); short- and long-term mortality, readmission, etc.) of inpatients with AECOPD and to establish and validate early warning models of these adverse outcomes, as described previously [ 19 ]. The diagnosis of AECOPD was based on the following criteria: (1) a history of COPD, including (i) exposure to risk factors (e.g., tobacco smoking, specific environment exposure); (ii) long-term dyspnea, chronic cough, or sputum production; (iii) postbronchodilator spirometry testing showing a forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) ratio less than 70%; and (2) an acute worsening of respiratory symptoms resulting in additional therapy.…”

Blood Eosinophils and Clinical Outcomes in Inpatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study

“…Patient inclusion was based on the prospective, multicenter cohort study MAGNET AECOPD (MAnaGement aNd advErse ouTcomes in inpatients with acute exacerbation of COPD) Registry study in China (ChiCTR2100044625). 18 This study prospectively included patients hospitalized for AECOPD in 10 large tertiary general hospitals in China from September 2017 to July 2021. The major aims of this registry study were to investigate the management and adverse outcomes (including mortality, ICU admission, invasive mechanical ventilation, readmission, etc.)…”