ICU sedation, delirium & recovery
Performance of Risk Assessment Models for VTE in Patients Who Are Critically Ill Receiving Pharmacologic Thromboprophylaxis: A Post Hoc Analysis of the Pneumatic Compression for Preventing VTE Trial
Authors' conclusion
The risk assessment models for VTE performed poorly in patients who are critically ill receiving pharmacologic thromboprophylaxis. None of the models identified a subgroup of patients who might benefit from adjunctive pneumatic compression.
Study context
- Population
- Critically ill patients receiving pharmacologic thromboprophylaxis198 (9.9%) developed VTE
- Participants
- 2,003 patients
- Comparison
- Six VTE risk assessment models (ICU-VTE, Kucher, Intermountain, Caprini, Padua, IMPROVE); adjunctive pneumatic compression vs none by risk subgroup
Methodological detailspost hoc analysis, diagnostic performance of risk assessment models
- Post hoc analysis
- Diagnostic performance of risk assessment models
Primary result
As reported in the abstract
Diagnostic performance of VTE risk assessment models (AUC, sensitivity, specificity, PPV, NPV)
| Group | AUC |
|---|---|
| Caprini | 0.64 (95% CI, 0.60-0.68) |
Caprini
AUC0.64 (95% CI, 0.60-0.68)
- All other risk assessment models: AUC
- < 0.60
- Caprini, Padua and Intermountain: sensitivity
- > 85%
- Caprini, Padua and Intermountain: specificity
- < 20%
- ICU-VTE, Kucher and IMPROVE: sensitivity
- < 15%
- ICU-VTE, Kucher and IMPROVE: specificity
- > 85%
- PPV, all studied cutoff scores
- < 20%
- NPV, mostly
- > 90%
Further findings
Independent predictors of VTE (multivariable logistic regression)
- APACHE II score, prior immobilization, femoral central venous catheter, invasive mechanical ventilation
Effect of adjunctive pneumatic compression vs pharmacologic prophylaxis alone in high- vs low-risk subgroups (subgroup)
- Effect did not differ across the subgroups
- Pinteraction > .05
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Performance of Risk Assessment Models for VTE in Patients Who Are Critically Ill Receiving Pharmacologic Thromboprophylaxis: A Post Hoc Analysis of the Pneumatic Compression for Preventing VTE Trial. Chest. Published 2 September 2024. doi:10.
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