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. 2020 Mar;18(3):676-680.
doi: 10.1111/jth.14688. Epub 2019 Dec 16.

External validation of the simplified Geneva risk assessment model for hospital-associated venous thromboembolism in the Padua cohort

Marc Blondon  1 , Marc Righini  1 , Mathieu Nendaz  2 , Frédéric Glauser  1 , Helia Robert-Ebadi  1 , Paolo Prandoni  3 , Sofia Barbar  4
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Free article

External validation of the simplified Geneva risk assessment model for hospital-associated venous thromboembolism in the Padua cohort

Marc Blondon et al. J Thromb Haemost. 2020 Mar.
Free article

Abstract

Background: The simplified Geneva risk assessment model (RAM) predicts the risk of hospitalization-related venous thromboembolism (VTE) in medical inpatients in its developmental cohort but has not been validated.

Objectives: To externally validate the simplified Geneva RAM.

Patients/methods: For this secondary analysis of a prospective cohort set in Padua, we calculated the simplified Geneva RAM for all participants. They were followed up for 90 days for the occurrence of adjudicated VTE. Thirty- and 90-day risks of VTE were estimated by the Kaplan-Meier method, and categories of risks compared with a Cox regression model adjusted for the use of thromboprophylaxis.

Results: Among 1180 medical inpatients, the 90-day risk of symptomatic VTE was 3.1%. The simplified Geneva RAM classified 56.9% as high risk (≥3 points; 90-day risk of VTE of 5.2%) and 43.1% as low risk (<3 points; 90-day risk of VTE of 0.4%). Compared with low-risk participants, high-risk participants had an 18-fold greater risk of VTE than low-risk participants (hazard ratio [HR] 17.9, 95% confidence interval [CI] 4.3-74.7). A very high-risk category (≥7 points) identified 5.3% of participants with a 9.5% probability of VTE at 90 days.

Conclusions: In this external validation study, we confirm the excellent discrimination and clinically adequate calibration of the simplified Geneva RAM as a stratification tool to guide the use of thromboprophylaxis.

Keywords: decision support techniques; hospitalization; pulmonary embolism; risk assessment; venous thrombosis.

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References

REFERENCES

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