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. 2024 Jan-Dec:30:10760296241271406.
doi: 10.1177/10760296241271406.

External Validation of the ICU-Venous Thromboembolism Risk Assessment Model in Adult Critically Ill Patients

Lijuan Zhang  1 , Fuyang Chen  1 , Su Hu  1 , Yanxia Zhong  1 , Bohua Wei  1 , Xiaopin Wang  1 , Ding Long  1
Affiliations

External Validation of the ICU-Venous Thromboembolism Risk Assessment Model in Adult Critically Ill Patients

Lijuan Zhang et al. Clin Appl Thromb Hemost. 2024 Jan-Dec.

Abstract

Background: Currently, no universally accepted standardized VTE risk assessment model (RAM) is specifically designed for critically ill patients. Although the ICU-venous thromboembolism (ICU-VTE) RAM was initially developed in 2020, it lacks prospective external validation.

Objectives: To evaluate the predictive performance of the ICU-VTE RAM in terms of VTE occurrence in mixed medical-surgical ICU patients.

Methods: We prospectively enrolled adult patients in the ICU. The ICU-VTE score and Caprini or Padua score were calculated at admission, and the incidence of in-hospital VTE was investigated. The performance of the ICU-VTE RAM was evaluated and compared with that of Caprini or Padua RAM using the receiver operating curve.

Results: We included 269 patients (median age: 70 years; 62.5% male). Eighty-three (30.9%) patients experienced inpatient VTE. The AUC of the ICU-VTE RAM was 0.743 (95% CI, 0.682-0.804, P < 0.001) for mixed medical-surgical ICU patients. Comparatively, the performance of the ICU-VTE RAM was superior to that of the Pauda RAM (AUC: 0.727 vs 0.583, P < 0.001) in critically ill medical patients and the Caprini RAM (AUC: 0.774 vs 0.617, P = 0.128) in critically ill surgical patients, although the latter comparison was not statistically significant.

Conclusions: The ICU-VTE RAM may be a practical and valuable tool for identifying and stratifying VTE risk in mixed medical-surgical critically ill patients, aiding in managing and preventing VTE complications.

Keywords: critically ill; inpatient; risk assessment model; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of this study.
Figure 2.
Figure 2.
Receiver operating characteristic (ROC) curve of the ICU-VTE risk assessment model (RAM) for the prediction of venous thromboembolism in critically ill patients. A. ROC curve of the ICU-VTE RAM in mixed medical-surgical critically ill patients. B. ROC curve of the ICU-VTE and Pauda RAM in critically ill medical patients. C. ROC curve of the ICU-VTE and Caprini RAM in critically ill surgical patients.
Figure 3.
Figure 3.
Receiver operating characteristic (ROC) curve of the ICU-VTE risk assessment model (RAM) for predicting symptomatic or asymptomatic venous thromboembolism in critically ill patients. A. ROC curve of the ICU-VTE RAM for the prediction of symptomatic venous thromboembolism. B. ROC curve of the ICU-VTE RAM for the prediction of asymptomatic venous thromboembolism.
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