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Risk assessment models predicted VTE risk in high-grade gliomas
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Researchers used biomarkers to develop two risk assessment models that accurately identified patients with newly diagnosed high-grade gliomas who were as high risk for venous thromboembolism, according to study results.
The models also identified patients at low risk for venous thromboembolism (VTE), a group for whom extended primary thromboprophylaxis may not be necessary.
Researchers evaluated 11 biomarkers in 141 patients with high-grade gliomas who underwent a neurosurgical intervention. Researchers developed two VTE risk assessment models, the first of which included the strongest predictors of VTE identified by statistical forward selection, and the second of which included parameters available in routine clinical practice.
Overall, 24 patients (17%) developed VTE during study follow-up.
Of the 11 biomarkers, results showed leukocyte count, platelet count, sP-selectin, prothrombin-fragment 1 and 2, FVIII activity and D-dimer were associated with risk for VTE occurrence.
The first risk assessment model evaluated patients for low platelet count — defined as a count in the lower 25th percentile of the study population — and elevated sP-selectin, defined has having levels in the 75th or greater percentile of the patient population. Researchers used these parameters to determine the probability of VTE after 12 months, with scores ranging from 0 to 3.
The cumulative probability for the 76 patients assigned a score of 0 was 9.7%. The cumulative probability increased to 18.9% among the 59 patients assigned a score of 1, and to 83.3% among the six patients assigned a score of 2.
The second risk assessment model determined risk according to platelet counts in the lower 25th percentile, leukocyte counts and elevated D-dimer level, defined as ≥75th percentile.
The cumulative probability for VTE was 3.3% among the 63 patients with a score of 0 and 23% among the 53 patients with a score of 1. The cumulative probability was 37.7% for patients assigned scores of 2 (n=22) and 3 (n=3).
“The application of two risk assessment models allowed identification of patients at high risk of developing VTE,” the researchers wrote. “We could also define patients at low risk of VTE, who would most probably not benefit from primary thromboprophylaxis.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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