机构：[1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China. National Center for Respiratory Medicine, Beijing, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China. National Clinical Research Center for Respiratory Diseases, Beijing, China.[2]Department of Respiratory and Critical Care Medicine, Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China四川大学华西医院[3]Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China[4]Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Respiratory Medicine, Huadong Hospital affiliated to Fudan University, Shanghai, China[5]Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, China[6]Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong, China[7]Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Henan, China
Background: Venous thromboembolism (VTE) prophylaxis remains suboptimal in China due to the bleeding risk associated with pharmacologic prophylaxis. We used data from the DissolVE-2 study to report the risk factors for bleeding and validated the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score (BRS). Methods: In-hospital major bleeding incidence in medical patients from the DissolVE-2 study were assessed by Kaplan-Meier method. Risk factors associated with clinically relevant bleeding (CRB) were analysed using Cox regression model. Sensitivity, specificity, positive predictive value, negative predictive value and receiver-operating characteristic (ROC) curve was used to compute the diagnostic accuracy of IMPROVE BRS in the study cohort. Findings: Of the 6623 medical patients, 5076 patients with all relevant clinical details were included for the validation cohort. Overall, 127 CRB events (38 major and 89 clinically relevant non-major bleeding events) occurred in this cohort, with a cumulative incidence rate of 2.6% (95% confidence interval [CI], 2.3-3.4). Application of IMPROVE BRS revealed significantly higher hazards of CRB (hazard ratio [HR]: 7.17, 95% CI, 5.05-10.18) and major bleeding (HR: 13.95, 95% CI, 7.28-26.73) in patients with IMPROVE BRS >= 7. Comparison of predictive parameters revealed higher sensitivity (44.1 vs 35.9) and positive predictive value (10.9 vs 2.6) for CRB in our study than the IMPROVE study, which was substantiated by the area under the curve (0.73, p<0.0001) from the ROC curve analysis. Interpretation: IMPROVE BRS is a simple model for estimating bleeding risk in Chinese medical patients and could be used in conjunction with VTE risk assessment models to decide prophylactic treatment for VTE. (C) 2020 The Authors. Published by Elsevier Ltd.
基金：
Sanofi (Beijing) Pharmaceutical Co, Ltd; Fund of The National Key Research and Development Program of China [2016YFC0905600]; CAMS Innovation Fund for Medical Sciences (CIFMS) [2018-I2M-1-003]
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
无
最新[2023]版：
大类|1 区医学
小类|1 区卫生保健与服务1 区公共卫生、环境卫生与职业卫生
JCR分区：
出版当年[2020]版：
无
最新[2023]版：
Q1HEALTH CARE SCIENCES & SERVICESQ1PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
第一作者机构：[1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China. National Center for Respiratory Medicine, Beijing, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China. National Clinical Research Center for Respiratory Diseases, Beijing, China.
通讯作者：
推荐引用方式(GB/T 7714)：
Zhang Zhu,Zhai Zhenguo,Li Weimin,et al.Validation of the IMPROVE bleeding risk score in Chinese medical patients during hospitalization: Findings from the dissolve-2 study[J].LANCET REGIONAL HEALTH-WESTERN PACIFIC.2020,4:doi:10.1016/j.lanwpc.2020.100054.
APA：
Zhang, Zhu,Zhai, Zhenguo,Li, Weimin,Qin, Xinyu,Qu, Jieming...&on behalf of the DissolVE-2 investigators.(2020).Validation of the IMPROVE bleeding risk score in Chinese medical patients during hospitalization: Findings from the dissolve-2 study.LANCET REGIONAL HEALTH-WESTERN PACIFIC,4,
MLA：
Zhang, Zhu,et al."Validation of the IMPROVE bleeding risk score in Chinese medical patients during hospitalization: Findings from the dissolve-2 study".LANCET REGIONAL HEALTH-WESTERN PACIFIC 4.(2020)
