Validation of a Prognostic Score to Identify Hospitalized Patients with COVID-19 at Increased Risk for Bleeding.
Viruses
; 13(11)2021 11 15.
Article
in English
| MEDLINE | ID: covidwho-1524170
ABSTRACT
INTRODUCTION:
Hospitalized patients with COVID-19 are at increased risk for venous thromboembolism (VTE), but also for bleeding. We previously derived a prognostic score including four variables (elevated D-dimer, elevated ferritin, critical illness, and therapeutic-dose anticoagulation) that identified those at increased risk for major bleeding.METHODS:
We aimed to validate the score in a subsequent cohort of hospitalized patients with COVID-19 receiving standard-, intermediate- or therapeutic doses of VTE prophylaxis. We evaluated its capacity to predict major bleeding, non-major bleeding, and bleeding-related death.RESULTS:
The cohort included 972 patients from 29 hospitals, of whom 280 (29%) received standard-; 412 (42%) intermediate-, 157 (16%) therapeutic doses of VTE prophylaxis and 123 (13%) other drugs. Median duration of prophylaxis was 14.7 ± 10.3 days. Major bleeding occurred in 65 patients (6.7%) and non-major bleeding in 67 (6.9%). Thirty patients with major bleeding (46%) died within the first 30 days after bleeding. The prognostic score identified 203 patients (21%) at very low risk, 285 (29%) at low risk, 263 (27%) intermediate-risk and 221 (23%) at high risk for bleeding. Major bleeding occurred in 1.0%, 2.1%, 8.7% and 15.4% of the patients, respectively. Non-major bleeding occurred in 0.5%, 3.5%, 9.5% and 14.2%, respectively. The c-statistics was 0.74 (95% confidence intervals [CI] 0.68-0.79) for major bleeding, 0.73 (95% CI 0.67-0.78) for non-major bleeding and 0.82 (95% CI 0.76-0.87) for bleeding-related death.CONCLUSIONS:
In hospitalized patients with COVID-19, we validated that a prognostic score including 4 easily available items may identify those at increased risk for bleeding.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Fibrin Fibrinogen Degradation Products
/
Ferritins
/
COVID-19
/
Hemorrhage
/
Anticoagulants
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
/
Male
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
V13112278
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