Development of a Risk Prediction Score for Occult Cancer in Patients With VTE

Luis Jara-Palomares, Remedios Otero, David Jimenez, Marc Carrier, Inna Tzoran, Benjamin Brenner, Mireia Margeli, Juan Manuel Praena-Fernandez, Elvira Grandone, Manuel Monreal, RIETE Investigators

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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.

Original languageEnglish
Pages (from-to)564-571
Number of pages8
JournalChest
Volume151
Issue number3
DOIs
Publication statusPublished - Mar 2017

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Neoplasms
Platelet Count
Lung Diseases
Registries
Case-Control Studies
Anemia
Chronic Disease

Keywords

  • Journal Article

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Jara-Palomares, L., Otero, R., Jimenez, D., Carrier, M., Tzoran, I., Brenner, B., ... RIETE Investigators (2017). Development of a Risk Prediction Score for Occult Cancer in Patients With VTE. Chest, 151(3), 564-571. https://doi.org/10.1016/j.chest.2016.10.025

Development of a Risk Prediction Score for Occult Cancer in Patients With VTE. / Jara-Palomares, Luis; Otero, Remedios; Jimenez, David; Carrier, Marc; Tzoran, Inna; Brenner, Benjamin; Margeli, Mireia; Praena-Fernandez, Juan Manuel; Grandone, Elvira; Monreal, Manuel; RIETE Investigators.

In: Chest, Vol. 151, No. 3, 03.2017, p. 564-571.

Research output: Contribution to journalArticle

Jara-Palomares, L, Otero, R, Jimenez, D, Carrier, M, Tzoran, I, Brenner, B, Margeli, M, Praena-Fernandez, JM, Grandone, E, Monreal, M & RIETE Investigators 2017, 'Development of a Risk Prediction Score for Occult Cancer in Patients With VTE', Chest, vol. 151, no. 3, pp. 564-571. https://doi.org/10.1016/j.chest.2016.10.025
Jara-Palomares L, Otero R, Jimenez D, Carrier M, Tzoran I, Brenner B et al. Development of a Risk Prediction Score for Occult Cancer in Patients With VTE. Chest. 2017 Mar;151(3):564-571. https://doi.org/10.1016/j.chest.2016.10.025
Jara-Palomares, Luis ; Otero, Remedios ; Jimenez, David ; Carrier, Marc ; Tzoran, Inna ; Brenner, Benjamin ; Margeli, Mireia ; Praena-Fernandez, Juan Manuel ; Grandone, Elvira ; Monreal, Manuel ; RIETE Investigators. / Development of a Risk Prediction Score for Occult Cancer in Patients With VTE. In: Chest. 2017 ; Vol. 151, No. 3. pp. 564-571.
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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 TromboEmb{\'o}lica) 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.",
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AU - Otero, Remedios

AU - Jimenez, David

AU - Carrier, Marc

AU - Tzoran, Inna

AU - Brenner, Benjamin

AU - Margeli, Mireia

AU - Praena-Fernandez, Juan Manuel

AU - Grandone, Elvira

AU - Monreal, Manuel

AU - RIETE Investigators

N1 - Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

PY - 2017/3

Y1 - 2017/3

N2 - 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.

AB - 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.

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