Assessment of risk for venous thromboembolism in hospital emergency departments: an analysis of concordance between scales

作者：Ruiz Artacho Pedro^*; Merlo Loranca Marta; Carrizosa Bach Mar; Antolin Santaliestra Albert; Llorens Sorian Pere; Jimenez Hernandez Sonia

来源：Emergencias, 2014, 26(5): 349-353.

• Thromboprophylaxis
• Hospital emergency health services
• Venous thromboembolism

Background and objective: Little information is available on differences between scales used to assess risk for venous thromboembolism (VTE) in patients with medical conditions admitted from hospital emergency departments. We aimed to evaluate the agreement between 2 risk prediction tools: a scale based on the PRETEMED guideline and the Padua Prediction Score (PPS). %26lt;br%26gt;Methods: Prospective multicenter cohort study in 6 Spanish hospital emergency departments. Patients with medical conditions requiring hospital admission were included between December 2011 and July 2012. The concordance correlation between the 2 scales was calculated. The development of VTE was registered for 90 days. %26lt;br%26gt;Results: Of 610 patients recruited, data for 580 patients (mean [SD] age, 70.1 [16.9] years; 45.3% women) were valid for assessment. Patients classified as having moderate or high risk numbered 256 (44.1%) with the PRETEMED scale and 368 (63.4%) with the PPS. The K index of concordance between the 2 scales was 0.39 (95% CI, 0.32-0.46) (discordance, 31.3%). Among patients who did not receive thromboprophylaxis, the incidence of VTE was 2.3% among the 129 patients the PRETEMED scale classified as being at moderate or high risk and 3.5% among patients at high risk according to the PPS. %26lt;br%26gt;Conclusions: There is disagreement between PRETEMED and PPS scale assessments of risk for VTE in patients with medical conditions. The PPS classified more patients as being at high risk, and the predictions were more accurate based on their later development of VTE.

• 出版日期2014-10