Ferreyro et al reported 2 scores for evaluating a patient with a recent venous thromboembolism (VTE). These can help to identify a patient who may benefit from a more complete evaluation. The authors are from Hospital Italiano de Buenos Aires and Buenos Aires University in Argentina.
Patient selection: adult >= 18 years of age with a venous thromboembolism
Outcomes: (1) diagnosis of cancer within one year, (2) death or diagnosis of cancer within 1 year
Parameters:
(1) history of previous venous thromboembolism
(2) history of recent surgery
(3) Charlson comorbidity index
(4) age of the patient in years
(5) serum albumin in g/dL
|
Parameter
|
Finding
|
Points
|
|
history of previous VTE
|
no
|
0
|
|
|
yes
|
3
|
|
history of recent surgery
|
no
|
1
|
|
|
yes
|
0
|
|
Charlson comorbidity
|
0 or 1
|
0
|
|
|
>= 2
|
1
|
|
age in years
|
< 70 years
|
0
|
|
|
>= 70 years
|
1
|
|
serum albumin
|
> 2.5 g/dL
|
0
|
|
|
<= 2.5 g/dL
|
2
|
total score for risk of cancer alone =
= SUM(points for first 3 parameters)
total score for risk of both cancer and death =
= SUM(points for all of the parameters)
Interpretation:
• minimum for both scores: 0
• maximum score for cancer alone: 5
• maximum score for both cancer and death: 8
• A score for cancer >=2 had a sensitivity of 59% and specificity of 78%.
• A score for both outcomes >= 2 had a sensitivity of 88% and specificity of 44%.
Performance:
• The area under the ROC curve for cancer alone was 75%.
• The area under the ROC curve for cancer or death was 72%.
