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Published in: Journal of Thrombosis and Thrombolysis 4/2024

14-03-2024 | Thrombosis

Prediction of mortality in acute pulmonary embolism in cancer-associated thrombosis (MAUPE-C): derivation and validation of a multivariable model

Authors: Mario Aramberri, Jesús González-Olmedo, Adrián García-Villa, Ane Villanueva, Cristina Castillo Maza, Susana García-Gutiérrez, Carmen Diaz-Pedroche

Published in: Journal of Thrombosis and Thrombolysis | Issue 4/2024

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Abstract

Optimal risk stratification of patients with cancer and pulmonary embolism (PE) remains unclear. We constructed a clinical prediction rule (CPR) named ‘MAUPE-C’ to identify patients with low 30 days mortality. The study retrospectively developed and internally validated a CPR for 30 days mortality in a cohort of patients with cancer and PE (both suspected and unsuspected). Candidate variables were chosen based on the EPIPHANY study, which categorized patients into 3 groups based on symptoms, signs, suspicion and patient setting at PE diagnosis. The performance of ‘MAUPE-C’ was compared to RIETE and sPESI scores. Univariate analysis confirmed that the presence of symptoms, signs, suspicion and inpatient diagnosis were associated with 30 days mortality. Multivariable logistic regression analysis led to the exclusion of symptoms as predictive variable. ‘MAUPE-C’ was developed by assigning weights to risk factors related to the β coefficient, yielding a score range of 0 to 4.5. After receiver operating characteristic (ROC) curve analysis, a cutoff point was established at ≤ 1. Prognostic accuracy was good with an area under the curve (AUC) of 0.77 (95% CI 0.71–0.82), outperforming RIETE and sPESI scores in this cohort (AUC of 0.64 [95% CI 0.57–0.71] and 0.57 [95% CI 0.49–0.65], respectively). Forty-five per cent of patients were classified as low risk and experienced a 2.79% 30 days mortality. MAUPE-C has good prognostic accuracy in identifying patients at low risk of 30 days mortality. This CPR could help physicians select patients for early discharge.
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Metadata
Title
Prediction of mortality in acute pulmonary embolism in cancer-associated thrombosis (MAUPE-C): derivation and validation of a multivariable model
Authors
Mario Aramberri
Jesús González-Olmedo
Adrián García-Villa
Ane Villanueva
Cristina Castillo Maza
Susana García-Gutiérrez
Carmen Diaz-Pedroche
Publication date
14-03-2024
Publisher
Springer US
Keyword
Thrombosis
Published in
Journal of Thrombosis and Thrombolysis / Issue 4/2024
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-024-02960-9

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