Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/214013 |
Resumo: | Objectives: Hospitalization during pregnancy and childbirth increases the risk of Venous Thromboembolism Risk (VTE). This study applied a VTE risk score to all hospitalized pregnant women to ascertain its effectiveness in preventing maternal death from VTE until 3 months after discharge. Methods: In this interventional study, patients were classified as low- or high-risk according to the VTE risk score (Clinics Hospital risk score). High-risk patients (score ≥ 3) were scheduled for pharmacological Thromboprophylaxis (TPX). Interaction analysis of the main risk factors was performed using Odds Ratio (OR) and Poisson regression with robust variance. Results: The data of 10694 cases (7212 patients) were analyzed; 1626 (15.2%, 1000 patients) and 9068 (84.8%, 6212 patients) cases were classified as high-risk (score ≥ 3) and low-risk (score < 3), respectively. The main risk factors (Odds Ratio, 95% Confidence Interval) for VTE were age ≥ 35 and < 40 years (1.6, 1.4–1.8), parity ≥ 3 (3.5, 3.0–4.0), age ≥ 40 years (4.8, 4.1–5.6), multiple pregnancies (2.1, 1.7–2.5), BMI ≥ 40 kg/m2 (5.1, 4.3–6.0), severe infection (4.1, 3.3–5.1), and cancer (12.3, 8.8–17.2). There were 10 cases of VTE: 7/1636 (0.4%) and 3/9068 (0.03%) in the high- and low-risk groups, respectively. No patient died of VTE. The intervention reduced the VTE risk by 87%; the number needed to treat was 3. Conclusions: This VTE risk score was effective in preventing maternal deaths from VTE, with a low indication for TPX. Maternal age, multiparity, obesity, severe infections, multiple pregnancies, and cancer were the main risk factors for VTE. |
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Clinics |
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Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trialVenous thromboembolismHospitalsPregnancyRisk factorMaternal deathNeoplasmsObjectives: Hospitalization during pregnancy and childbirth increases the risk of Venous Thromboembolism Risk (VTE). This study applied a VTE risk score to all hospitalized pregnant women to ascertain its effectiveness in preventing maternal death from VTE until 3 months after discharge. Methods: In this interventional study, patients were classified as low- or high-risk according to the VTE risk score (Clinics Hospital risk score). High-risk patients (score ≥ 3) were scheduled for pharmacological Thromboprophylaxis (TPX). Interaction analysis of the main risk factors was performed using Odds Ratio (OR) and Poisson regression with robust variance. Results: The data of 10694 cases (7212 patients) were analyzed; 1626 (15.2%, 1000 patients) and 9068 (84.8%, 6212 patients) cases were classified as high-risk (score ≥ 3) and low-risk (score < 3), respectively. The main risk factors (Odds Ratio, 95% Confidence Interval) for VTE were age ≥ 35 and < 40 years (1.6, 1.4–1.8), parity ≥ 3 (3.5, 3.0–4.0), age ≥ 40 years (4.8, 4.1–5.6), multiple pregnancies (2.1, 1.7–2.5), BMI ≥ 40 kg/m2 (5.1, 4.3–6.0), severe infection (4.1, 3.3–5.1), and cancer (12.3, 8.8–17.2). There were 10 cases of VTE: 7/1636 (0.4%) and 3/9068 (0.03%) in the high- and low-risk groups, respectively. No patient died of VTE. The intervention reduced the VTE risk by 87%; the number needed to treat was 3. Conclusions: This VTE risk score was effective in preventing maternal deaths from VTE, with a low indication for TPX. Maternal age, multiparity, obesity, severe infections, multiple pregnancies, and cancer were the main risk factors for VTE.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2023-06-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21401310.1016/j.clinsp.2023.100230Clinics; Vol. 78 (2023); 100230Clinics; v. 78 (2023); 100230Clinics; Vol. 78 (2023); 1002301980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/214013/196223Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessBarros, Venina Isabel Poço Viana Leme deIgai, Ana Maria KondoBaptista, Fernanda SpadottoBortolotto, Maria Rita de Figueiredo LemosPeres, Stela VerzinhasseFrancisco, Rossana Pulcinelli Vieira2023-07-06T13:05:40Zoai:revistas.usp.br:article/214013Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:05:40Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
title |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
spellingShingle |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial Barros, Venina Isabel Poço Viana Leme de Venous thromboembolism Hospitals Pregnancy Risk factor Maternal death Neoplasms |
title_short |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
title_full |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
title_fullStr |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
title_full_unstemmed |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
title_sort |
Venous thromboembolism risk score during hospitalization in pregnancy: results of 10694 prospective evaluations in a clinical trial |
author |
Barros, Venina Isabel Poço Viana Leme de |
author_facet |
Barros, Venina Isabel Poço Viana Leme de Igai, Ana Maria Kondo Baptista, Fernanda Spadotto Bortolotto, Maria Rita de Figueiredo Lemos Peres, Stela Verzinhasse Francisco, Rossana Pulcinelli Vieira |
author_role |
author |
author2 |
Igai, Ana Maria Kondo Baptista, Fernanda Spadotto Bortolotto, Maria Rita de Figueiredo Lemos Peres, Stela Verzinhasse Francisco, Rossana Pulcinelli Vieira |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Barros, Venina Isabel Poço Viana Leme de Igai, Ana Maria Kondo Baptista, Fernanda Spadotto Bortolotto, Maria Rita de Figueiredo Lemos Peres, Stela Verzinhasse Francisco, Rossana Pulcinelli Vieira |
dc.subject.por.fl_str_mv |
Venous thromboembolism Hospitals Pregnancy Risk factor Maternal death Neoplasms |
topic |
Venous thromboembolism Hospitals Pregnancy Risk factor Maternal death Neoplasms |
description |
Objectives: Hospitalization during pregnancy and childbirth increases the risk of Venous Thromboembolism Risk (VTE). This study applied a VTE risk score to all hospitalized pregnant women to ascertain its effectiveness in preventing maternal death from VTE until 3 months after discharge. Methods: In this interventional study, patients were classified as low- or high-risk according to the VTE risk score (Clinics Hospital risk score). High-risk patients (score ≥ 3) were scheduled for pharmacological Thromboprophylaxis (TPX). Interaction analysis of the main risk factors was performed using Odds Ratio (OR) and Poisson regression with robust variance. Results: The data of 10694 cases (7212 patients) were analyzed; 1626 (15.2%, 1000 patients) and 9068 (84.8%, 6212 patients) cases were classified as high-risk (score ≥ 3) and low-risk (score < 3), respectively. The main risk factors (Odds Ratio, 95% Confidence Interval) for VTE were age ≥ 35 and < 40 years (1.6, 1.4–1.8), parity ≥ 3 (3.5, 3.0–4.0), age ≥ 40 years (4.8, 4.1–5.6), multiple pregnancies (2.1, 1.7–2.5), BMI ≥ 40 kg/m2 (5.1, 4.3–6.0), severe infection (4.1, 3.3–5.1), and cancer (12.3, 8.8–17.2). There were 10 cases of VTE: 7/1636 (0.4%) and 3/9068 (0.03%) in the high- and low-risk groups, respectively. No patient died of VTE. The intervention reduced the VTE risk by 87%; the number needed to treat was 3. Conclusions: This VTE risk score was effective in preventing maternal deaths from VTE, with a low indication for TPX. Maternal age, multiparity, obesity, severe infections, multiple pregnancies, and cancer were the main risk factors for VTE. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-10 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/214013 10.1016/j.clinsp.2023.100230 |
url |
https://www.revistas.usp.br/clinics/article/view/214013 |
identifier_str_mv |
10.1016/j.clinsp.2023.100230 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/214013/196223 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 78 (2023); 100230 Clinics; v. 78 (2023); 100230 Clinics; Vol. 78 (2023); 100230 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222767396683776 |