Development of a Risk Prediction Score for Occult Cancer in Patients With VTE
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 (Re...
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| Veröffentlicht in: | Chest 2017-03, Vol.151 (3), p.564-571 |
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| creator | Jara-Palomares, Luis, MD, PhD Otero, Remedios, MD, PhD Jimenez, David, PhD Carrier, Marc, MD Tzoran, Inna, MD Brenner, Benjamin, MD Margeli, Mireia, MD Praena-Fernandez, Juan Manuel, PhD Grandone, Elvira, MD, PhD Monreal, Manuel, MD, PhD |
| description | 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. |
| doi_str_mv | 10.1016/j.chest.2016.10.025 |
| format | Article |
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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.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1016/j.chest.2016.10.025</identifier><identifier>PMID: 27815153</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Anemia - epidemiology ; Case-Control Studies ; Female ; Humans ; Lung Diseases - epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; neoplasm ; Neoplasms - diagnosis ; Neoplasms - epidemiology ; pulmonary embolism ; Pulmonary Embolism - epidemiology ; Pulmonary/Respiratory ; Registries ; Reproducibility of Results ; risk ; Risk Assessment ; screening ; Sex Factors ; Spain - epidemiology ; Surgical Procedures, Operative - statistics & numerical data ; Thrombocytosis - epidemiology ; venous thromboembolism ; Venous Thromboembolism - epidemiology ; Venous Thrombosis - epidemiology</subject><ispartof>Chest, 2017-03, Vol.151 (3), p.564-571</ispartof><rights>American College of Chest Physicians</rights><rights>2016 American College of Chest Physicians</rights><rights>Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-983bfe83061c5a877d5e58258f32b0fc1a499aef50025db955888ff61ba652cd3</citedby><cites>FETCH-LOGICAL-c414t-983bfe83061c5a877d5e58258f32b0fc1a499aef50025db955888ff61ba652cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27815153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jara-Palomares, Luis, MD, PhD</creatorcontrib><creatorcontrib>Otero, Remedios, MD, PhD</creatorcontrib><creatorcontrib>Jimenez, David, PhD</creatorcontrib><creatorcontrib>Carrier, Marc, MD</creatorcontrib><creatorcontrib>Tzoran, Inna, MD</creatorcontrib><creatorcontrib>Brenner, Benjamin, MD</creatorcontrib><creatorcontrib>Margeli, Mireia, MD</creatorcontrib><creatorcontrib>Praena-Fernandez, Juan Manuel, PhD</creatorcontrib><creatorcontrib>Grandone, Elvira, MD, PhD</creatorcontrib><creatorcontrib>Monreal, Manuel, MD, PhD</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><title>Development of a Risk Prediction Score for Occult Cancer in Patients With VTE</title><title>Chest</title><addtitle>Chest</addtitle><description>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.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia - epidemiology</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Diseases - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>neoplasm</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - epidemiology</subject><subject>pulmonary embolism</subject><subject>Pulmonary Embolism - epidemiology</subject><subject>Pulmonary/Respiratory</subject><subject>Registries</subject><subject>Reproducibility of Results</subject><subject>risk</subject><subject>Risk Assessment</subject><subject>screening</subject><subject>Sex Factors</subject><subject>Spain - epidemiology</subject><subject>Surgical Procedures, Operative - statistics & numerical data</subject><subject>Thrombocytosis - epidemiology</subject><subject>venous thromboembolism</subject><subject>Venous Thromboembolism - epidemiology</subject><subject>Venous Thrombosis - epidemiology</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFP3DAQhS3UCrbAL6hU-dhLFo-99jqHVqoWKJWoQAXK0XKcsfCSjRc7QeLf1-nSHnrpaTSj9-ZpviHkPbA5MFAn67l7wDzMeWnKZM643CMzqAVUQi7EGzJjDHglVM0PyLuc16z0UKt9csCXGiRIMSPfT_EZu7jdYD_Q6KmlP0J-pNcJ2-CGEHt642JC6mOiV86N3UBXtneYaOjptR1C8WV6H4YH-vP27Ii89bbLePxaD8nd-dnt6qK6vPr6bfXlsnILWAxVrUXjUQumwEmrl8tWotRcai94w7wDu6hri16yclPb1FJqrb1X0FgluWvFIfm427tN8WksEMwmZIddZ3uMYzaghVoKLmVdpGIndSnmnNCbbQobm14MMDNxNGvzm6OZOE7DkllcH14DxmaD7V_PH3BF8GknwHLmc8BksissXMGW0A2mjeE_AZ__8bsu9MHZ7hFfMK_jmPpC0IDJ3DBzM71y-iQoxbnmIH4B0KGX-w</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Jara-Palomares, Luis, MD, PhD</creator><creator>Otero, Remedios, MD, PhD</creator><creator>Jimenez, David, PhD</creator><creator>Carrier, Marc, MD</creator><creator>Tzoran, Inna, MD</creator><creator>Brenner, Benjamin, MD</creator><creator>Margeli, Mireia, MD</creator><creator>Praena-Fernandez, Juan Manuel, PhD</creator><creator>Grandone, Elvira, MD, PhD</creator><creator>Monreal, Manuel, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Development of a Risk Prediction Score for Occult Cancer in Patients With VTE</title><author>Jara-Palomares, Luis, MD, PhD ; Otero, Remedios, MD, PhD ; Jimenez, David, PhD ; Carrier, Marc, MD ; Tzoran, Inna, MD ; Brenner, Benjamin, MD ; Margeli, Mireia, MD ; Praena-Fernandez, Juan Manuel, PhD ; Grandone, Elvira, MD, PhD ; Monreal, Manuel, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-983bfe83061c5a877d5e58258f32b0fc1a499aef50025db955888ff61ba652cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia - epidemiology</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Diseases - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>neoplasm</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - epidemiology</topic><topic>pulmonary embolism</topic><topic>Pulmonary Embolism - epidemiology</topic><topic>Pulmonary/Respiratory</topic><topic>Registries</topic><topic>Reproducibility of Results</topic><topic>risk</topic><topic>Risk Assessment</topic><topic>screening</topic><topic>Sex Factors</topic><topic>Spain - epidemiology</topic><topic>Surgical Procedures, Operative - statistics & numerical data</topic><topic>Thrombocytosis - epidemiology</topic><topic>venous thromboembolism</topic><topic>Venous Thromboembolism - epidemiology</topic><topic>Venous Thrombosis - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jara-Palomares, Luis, MD, PhD</creatorcontrib><creatorcontrib>Otero, Remedios, MD, PhD</creatorcontrib><creatorcontrib>Jimenez, David, PhD</creatorcontrib><creatorcontrib>Carrier, Marc, MD</creatorcontrib><creatorcontrib>Tzoran, Inna, MD</creatorcontrib><creatorcontrib>Brenner, Benjamin, MD</creatorcontrib><creatorcontrib>Margeli, Mireia, MD</creatorcontrib><creatorcontrib>Praena-Fernandez, Juan Manuel, PhD</creatorcontrib><creatorcontrib>Grandone, Elvira, MD, PhD</creatorcontrib><creatorcontrib>Monreal, Manuel, MD, PhD</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jara-Palomares, Luis, MD, PhD</au><au>Otero, Remedios, MD, PhD</au><au>Jimenez, David, PhD</au><au>Carrier, Marc, MD</au><au>Tzoran, Inna, MD</au><au>Brenner, Benjamin, MD</au><au>Margeli, Mireia, MD</au><au>Praena-Fernandez, Juan Manuel, PhD</au><au>Grandone, Elvira, MD, PhD</au><au>Monreal, Manuel, MD, PhD</au><aucorp>RIETE Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of a Risk Prediction Score for Occult Cancer in Patients With VTE</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>151</volume><issue>3</issue><spage>564</spage><epage>571</epage><pages>564-571</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27815153</pmid><doi>10.1016/j.chest.2016.10.025</doi><tpages>8</tpages></addata></record> |
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| subjects | Age Factors Aged Aged, 80 and over Anemia - epidemiology Case-Control Studies Female Humans Lung Diseases - epidemiology Male Middle Aged Multivariate Analysis neoplasm Neoplasms - diagnosis Neoplasms - epidemiology pulmonary embolism Pulmonary Embolism - epidemiology Pulmonary/Respiratory Registries Reproducibility of Results risk Risk Assessment screening Sex Factors Spain - epidemiology Surgical Procedures, Operative - statistics & numerical data Thrombocytosis - epidemiology venous thromboembolism Venous Thromboembolism - epidemiology Venous Thrombosis - epidemiology |
| title | Development of a Risk Prediction Score for Occult Cancer in Patients With VTE |
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