风险评估模型的比较评估,用于预测植入中央静脉接入装置的癌症患者的静脉血栓栓塞事件
Mohammad Ma'koseh1,2, Heba Farfoura3, Mahmoud Abunasser1,2
1Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan.
Cancers
|October 29, 2025
概括
植入中央静脉接入装置 (ICVAD) 的癌症患者患有静脉血栓栓塞 (VTE) 的高风险. 在预测整体VTE事件方面,ONKOTEV风险评估模型 (RAM) 显示出最佳性能.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 医疗器械 医疗器械
背景情况:
- 癌症患者使用植入的中央静脉接入装置 (ICVAD) 进行化疗,面临静脉血栓栓塞 (VTE) 的风险增加.
- 在这个特定人群中,对VTE的风险评估模型 (RAM) 尚未得到研究.
- 了解VTE发生率和预测因素对于患者管理至关重要.
研究的目的:
- 评估ICVADs的癌症患者VTE的发生率.
- 在这个队列中确定与VTE相关的风险因素.
- 评估Khorana,COMPASS-CAT和ONKOTEV风险评估模型对VTE的预测性能.
主要方法:
- 通过ICVADs通过化疗治疗的成年癌症患者的回顾性审查.
- 使用细灰色方法估计的VTE的累积发病率.
- 通过灵敏度,特异性,预测值,准确度和AUC评估RAM性能;使用卡普兰-梅尔和日志等级测试分析的整体存活率.
主要成果:
- 总共有446名患者被纳入;18.4%的患者经历了VTE,其中9.6%与ICVAD相关.
- 一年后,VTE的累积发病率为9%,两年后为18.4%.
- 对于整体VTE,ONKOTEV表现出最好的预测性能 (准确率74.4%,AUC 0.607),但所有模型对ICVAD相关的VTE的能力有限. 静脉瘤与较低的整体存活率 (HR 1.39) 有关.
结论:
- 患有ICVAD的癌症患者具有早期VTE的显著风险.
- 在整体VTE预测方面,ONKOTEV RAM的表现最好,但在ICVAD相关事件方面表现不佳.
- 需要进行前性研究来验证RAM并指导VTE预防策略.
相关概念视频
01:29Venous Thrombosis III: Interprofessional Care
276
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
276
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
284
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
284
01:30Venous Thrombosis IV: Nursing Management
192
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
192
01:30Venous Thrombosis I: Introduction
351
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
351
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
397
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
397
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
179
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
179