tetano
Editor, Senior Moderator
QJM
. 2020 Jul 11;hcaa224.
doi: 10.1093/qjmed/hcaa224. Online ahead of print.
Association of Padua Prediction Score With In-Hospital Prognosis in COVID-19 Patients
Da-Xiong Zeng[SUP] 1 [/SUP], Jia-Li Xu[SUP] 1 [/SUP], Qiu-Xia Mao[SUP] 1 [/SUP], Rui Liu[SUP] 1 [/SUP], Wei-Yun Zhang[SUP] 1 [/SUP], Hong-Ying Qian[SUP] 1 [/SUP], Lan Xu[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Nearly 20% novel coronavirus disease 2019 (COVID-19) patients have abnormal coagulation function. Padua prediction score (PPS) is a validated tools for venous thromboembolism (VTE) risk assessment. However, its clinical value in COVID-19 patients evaluation was unclear.
Methods: We prospectively evaluated the VTE risk of COVID-19 patients using PPS. Demographic and clinical data were collected. Association of PPS with 28-days mortality was analyzed by multivariate logistic regression and Kaplan-Meier analysis.
Results: 274 continuous patients were enrolled, with total mortality of 17.2%. Patients in high PPS group, with significantly abnormal coagulation, have a higher levels of interleukin 6 (25.27 pg/ml vs.2.55 pg/ml, P < 0.001), prophylactic anticoagulation rate (60.7% vs. 6.5%, P<0.001) and mortality (40.5% vs. 5.9%, P<0.001) as compared with that in low PPS group. Critical patients showed higher PPS (6 score vs. 2 score, P<0.001) than that in severe patients. Multivariate logistic regression revealed the independent risk factors of in-hospital mortality included high PPS (OR: 7.35, 95%CI: 3.08 - 16.01), increased interleukin-6 (OR: 11.79, 95%CI: 5.45 - 26.20) and elevated d-dimer (OR: 4.65, 95%CI: 1.15 - 12.15). Kaplan-Meier analysis indicated patients with higher PPS had a significant survival disadvantage. Prophylactic anticoagulation in higher PPS patients show a mild advantage of mortality but without statistical significance (37.1% vs. 45.7%, P=0.42).
Conclusion: Higher PPS associated with in-hospital poor prognosis in COVID-19 patients. Prophylactic anticoagulation showed a mild advantage of mortality in COVID-19 patients with higher PPS, but it remain need further investigation.
Keywords: COVID-19; Padua prediction score; prognosis; venous thromboembolism.
. 2020 Jul 11;hcaa224.
doi: 10.1093/qjmed/hcaa224. Online ahead of print.
Association of Padua Prediction Score With In-Hospital Prognosis in COVID-19 Patients
Da-Xiong Zeng[SUP] 1 [/SUP], Jia-Li Xu[SUP] 1 [/SUP], Qiu-Xia Mao[SUP] 1 [/SUP], Rui Liu[SUP] 1 [/SUP], Wei-Yun Zhang[SUP] 1 [/SUP], Hong-Ying Qian[SUP] 1 [/SUP], Lan Xu[SUP] 2 [/SUP]
Affiliations
- PMID: 32652021
- DOI: 10.1093/qjmed/hcaa224
Abstract
Background: Nearly 20% novel coronavirus disease 2019 (COVID-19) patients have abnormal coagulation function. Padua prediction score (PPS) is a validated tools for venous thromboembolism (VTE) risk assessment. However, its clinical value in COVID-19 patients evaluation was unclear.
Methods: We prospectively evaluated the VTE risk of COVID-19 patients using PPS. Demographic and clinical data were collected. Association of PPS with 28-days mortality was analyzed by multivariate logistic regression and Kaplan-Meier analysis.
Results: 274 continuous patients were enrolled, with total mortality of 17.2%. Patients in high PPS group, with significantly abnormal coagulation, have a higher levels of interleukin 6 (25.27 pg/ml vs.2.55 pg/ml, P < 0.001), prophylactic anticoagulation rate (60.7% vs. 6.5%, P<0.001) and mortality (40.5% vs. 5.9%, P<0.001) as compared with that in low PPS group. Critical patients showed higher PPS (6 score vs. 2 score, P<0.001) than that in severe patients. Multivariate logistic regression revealed the independent risk factors of in-hospital mortality included high PPS (OR: 7.35, 95%CI: 3.08 - 16.01), increased interleukin-6 (OR: 11.79, 95%CI: 5.45 - 26.20) and elevated d-dimer (OR: 4.65, 95%CI: 1.15 - 12.15). Kaplan-Meier analysis indicated patients with higher PPS had a significant survival disadvantage. Prophylactic anticoagulation in higher PPS patients show a mild advantage of mortality but without statistical significance (37.1% vs. 45.7%, P=0.42).
Conclusion: Higher PPS associated with in-hospital poor prognosis in COVID-19 patients. Prophylactic anticoagulation showed a mild advantage of mortality in COVID-19 patients with higher PPS, but it remain need further investigation.
Keywords: COVID-19; Padua prediction score; prognosis; venous thromboembolism.