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The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease

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The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease. / Behrendt, Christian-Alexander; Kreutzburg, Thea; Nordanstig, Joakim; Twine, Christopher P; Marschall, Ursula; Kakkos, Stavros; Aboyans, Victor; Peters, Frederik.

In: EUR J VASC ENDOVASC, Vol. 63, No. 3, 03.2022, p. 503-510.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Behrendt, C-A, Kreutzburg, T, Nordanstig, J, Twine, CP, Marschall, U, Kakkos, S, Aboyans, V & Peters, F 2022, 'The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease', EUR J VASC ENDOVASC, vol. 63, no. 3, pp. 503-510. https://doi.org/10.1016/j.ejvs.2021.12.019

APA

Behrendt, C-A., Kreutzburg, T., Nordanstig, J., Twine, C. P., Marschall, U., Kakkos, S., Aboyans, V., & Peters, F. (2022). The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease. EUR J VASC ENDOVASC, 63(3), 503-510. https://doi.org/10.1016/j.ejvs.2021.12.019

Vancouver

Behrendt C-A, Kreutzburg T, Nordanstig J, Twine CP, Marschall U, Kakkos S et al. The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease. EUR J VASC ENDOVASC. 2022 Mar;63(3):503-510. https://doi.org/10.1016/j.ejvs.2021.12.019

Bibtex

@article{2544326866874b7092095003c86be100,
title = "The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease",
abstract = "OBJECTIVE: There is a paucity of evidence concerning the risk of bleeding after hospitalisation for symptomatic peripheral artery disease (PAD) in everyday clinical practice, as randomised clinical trials commonly exclude patients with heightened risk. The current study aimed to develop a pragmatic risk score that enables prediction of major bleeding during the first year after index discharge.METHODS: Unselected retrospective data from the second largest insurance fund in Germany, BARMER, were used to identify patients with a first hospitalisation for PAD registered between 1 January 2010 and 31 December 2018. Within a separate training cohort, final predictors were selected using penalised Cox regression (least absolute shrinkage and selection operator with ten fold cross validation) with one year major bleeding requiring hospitalisation as outcome. The risk score was internally validated. Four different risk groups were constructed.RESULTS: A total of 81 930 patients (47.2% female, 72.3 years) underwent hospitalisation for symptomatic PAD. After one year, 1 831 (2.2%) of the patients had a major bleeding event. Independent predictors were previous oral anticoagulation, age over 80, chronic limb threatening ischaemia, congestive heart failure, severe chronic kidney disease, previous bleeding event, anaemia, and dementia. The OAC3-PAD risk score exhibited adequate calibration and discrimination between four risk groups (c = 0.69, 95% confidence interval 0.67 - 0.71) from low risk (1.3%) to high risk (6.4%).CONCLUSION: A pragmatic risk score was developed to predict the individual major bleeding risk classifying a fifth of the cohort as high risk patients. Individual prediction scores such as the one proposed here may help to inform the risk and benefit of intensified antithrombotic strategies.",
keywords = "Aged, Female, Hemorrhage/diagnosis, Hospitalization, Humans, Male, Peripheral Arterial Disease/drug therapy, Retrospective Studies, Risk Factors",
author = "Christian-Alexander Behrendt and Thea Kreutzburg and Joakim Nordanstig and Twine, {Christopher P} and Ursula Marschall and Stavros Kakkos and Victor Aboyans and Frederik Peters",
note = "Copyright {\textcopyright} 2021 The Author(s). Published by Elsevier B.V. All rights reserved.",
year = "2022",
month = mar,
doi = "10.1016/j.ejvs.2021.12.019",
language = "English",
volume = "63",
pages = "503--510",
journal = "EUR J VASC ENDOVASC",
issn = "1078-5884",
publisher = "W.B. Saunders Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - The OAC3-PAD Risk Score Predicts Major Bleeding Events one Year after Hospitalisation for Peripheral Artery Disease

AU - Behrendt, Christian-Alexander

AU - Kreutzburg, Thea

AU - Nordanstig, Joakim

AU - Twine, Christopher P

AU - Marschall, Ursula

AU - Kakkos, Stavros

AU - Aboyans, Victor

AU - Peters, Frederik

N1 - Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

PY - 2022/3

Y1 - 2022/3

N2 - OBJECTIVE: There is a paucity of evidence concerning the risk of bleeding after hospitalisation for symptomatic peripheral artery disease (PAD) in everyday clinical practice, as randomised clinical trials commonly exclude patients with heightened risk. The current study aimed to develop a pragmatic risk score that enables prediction of major bleeding during the first year after index discharge.METHODS: Unselected retrospective data from the second largest insurance fund in Germany, BARMER, were used to identify patients with a first hospitalisation for PAD registered between 1 January 2010 and 31 December 2018. Within a separate training cohort, final predictors were selected using penalised Cox regression (least absolute shrinkage and selection operator with ten fold cross validation) with one year major bleeding requiring hospitalisation as outcome. The risk score was internally validated. Four different risk groups were constructed.RESULTS: A total of 81 930 patients (47.2% female, 72.3 years) underwent hospitalisation for symptomatic PAD. After one year, 1 831 (2.2%) of the patients had a major bleeding event. Independent predictors were previous oral anticoagulation, age over 80, chronic limb threatening ischaemia, congestive heart failure, severe chronic kidney disease, previous bleeding event, anaemia, and dementia. The OAC3-PAD risk score exhibited adequate calibration and discrimination between four risk groups (c = 0.69, 95% confidence interval 0.67 - 0.71) from low risk (1.3%) to high risk (6.4%).CONCLUSION: A pragmatic risk score was developed to predict the individual major bleeding risk classifying a fifth of the cohort as high risk patients. Individual prediction scores such as the one proposed here may help to inform the risk and benefit of intensified antithrombotic strategies.

AB - OBJECTIVE: There is a paucity of evidence concerning the risk of bleeding after hospitalisation for symptomatic peripheral artery disease (PAD) in everyday clinical practice, as randomised clinical trials commonly exclude patients with heightened risk. The current study aimed to develop a pragmatic risk score that enables prediction of major bleeding during the first year after index discharge.METHODS: Unselected retrospective data from the second largest insurance fund in Germany, BARMER, were used to identify patients with a first hospitalisation for PAD registered between 1 January 2010 and 31 December 2018. Within a separate training cohort, final predictors were selected using penalised Cox regression (least absolute shrinkage and selection operator with ten fold cross validation) with one year major bleeding requiring hospitalisation as outcome. The risk score was internally validated. Four different risk groups were constructed.RESULTS: A total of 81 930 patients (47.2% female, 72.3 years) underwent hospitalisation for symptomatic PAD. After one year, 1 831 (2.2%) of the patients had a major bleeding event. Independent predictors were previous oral anticoagulation, age over 80, chronic limb threatening ischaemia, congestive heart failure, severe chronic kidney disease, previous bleeding event, anaemia, and dementia. The OAC3-PAD risk score exhibited adequate calibration and discrimination between four risk groups (c = 0.69, 95% confidence interval 0.67 - 0.71) from low risk (1.3%) to high risk (6.4%).CONCLUSION: A pragmatic risk score was developed to predict the individual major bleeding risk classifying a fifth of the cohort as high risk patients. Individual prediction scores such as the one proposed here may help to inform the risk and benefit of intensified antithrombotic strategies.

KW - Aged

KW - Female

KW - Hemorrhage/diagnosis

KW - Hospitalization

KW - Humans

KW - Male

KW - Peripheral Arterial Disease/drug therapy

KW - Retrospective Studies

KW - Risk Factors

U2 - 10.1016/j.ejvs.2021.12.019

DO - 10.1016/j.ejvs.2021.12.019

M3 - SCORING: Journal article

C2 - 35125278

VL - 63

SP - 503

EP - 510

JO - EUR J VASC ENDOVASC

JF - EUR J VASC ENDOVASC

SN - 1078-5884

IS - 3

ER -