Predictive value of the Kuijer score for bleeding and other adverse in-hospital events in patients with venous thromboembolism

Background - Venous thromboembolism (VTE) constitute a major global burden of disease. Current international guidelines recommend treatment with anticoagulant therapy after VTE for a duration of at least 3 months. Since anticoagulation also imposes an increased risk for bleeding events, the individu...

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Hauptverfasser: Keller, Karsten (VerfasserIn) , Münzel, Thomas (VerfasserIn) , Hobohm, Lukas (VerfasserIn) , Ostad, Mir A. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2021
In: International journal of cardiology
Year: 2020, Jahrgang: 329, Pages: 179-184
ISSN:1874-1754
DOI:10.1016/j.ijcard.2020.11.075
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ijcard.2020.11.075
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0167527320342467
Volltext
Verfasserangaben:Karsten Keller, Thomas Münzel, Lukas Hobohm, Mir A. Ostad
Beschreibung
Zusammenfassung:Background - Venous thromboembolism (VTE) constitute a major global burden of disease. Current international guidelines recommend treatment with anticoagulant therapy after VTE for a duration of at least 3 months. Since anticoagulation also imposes an increased risk for bleeding events, the individual risk has to be evaluated to determine adequate treatment plans. - Methods - The nationwide German inpatient sample of the years 2005-2017 was used for this analysis. Hospitalized VTE patients were stratified according to Kuijer risk class and the performance of the Kuijer score was evaluated to predict adverse in-hospital events. - Results - Overall, 1,204,895 VTE patients were treated between 2005 and 2017 in Germany and were included in the present study (839,143 patients had deep venous thrombosis and/or thrombophlebitis and 669,881 patients pulmonary embolism). According to Kuijer risk class stratification, in total, 176,723 (14.7%) of the hospitalized VTE patients were classified as low risk, 914,964 (75.9%) as intermediate risk and 113,208 (9.4%) as high risk. A higher Kuijer risk class was predictive for in-hospital death (odds ratio [OR] 1.99 [95% confidence interval (CI) 1.96-2.02], P < 0.001), major adverse cardiovascular and cerebrovascular events (MACCE, OR 1.90 [95%CI 1.87-1.93], P < 0.001), intracerebral bleeding (OR 1.28 [95%CI 1.14-1.44], P < 0.001), gastrointestinal bleeding (OR 1.56 [95%CI 1.48-1.64], P < 0.001) as well as necessity of transfusion of blood constituents (OR 2.94 [95%CI 2.88-3.00], P < 0.001) independently of important comorbidities. - Conclusions - The Kuijer score is an important risk stratification tool to predict individual risk regarding in-hospital outcomes comprising major bleeding events such as intracerebral bleeding and necessity of transfusion of blood constituents, but also in-hospital mortality and MACCE in VTE patients.
Beschreibung:Available online 8 December 2020
Gesehen am 21.05.2021
Beschreibung:Online Resource
ISSN:1874-1754
DOI:10.1016/j.ijcard.2020.11.075