SARS-CoV-2 and Finding of Vein Thrombosis: Can IMPROVE and IMPROVEDD Scores Predict COVID-19 Outcomes?

Greco, Sonia; Zenunaj, Gladiol; Bonsi, Beatrice; Bella, A.P.A. Della; Lopreiato, Maeve C.; Luciani, Fabio

doi:10.1016/j.jvsv.2021.06.003

Cited by 9 publications

(18 citation statements)

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“…To better assess the individual patients' risk for developing a thrombotic complication, we calculated the IMPROVE risk scores for all the patients. Since D-dimer levels were not routinely measured during the hospitalization, we calculated the IMPROVE and not IMPROVE-DD score [17,36,37]. However, we did not observe a clear association between a high IMPROVE score and the thromboembolic complication rates in our cohort.…”

Section: Discussionmentioning

confidence: 76%

Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery

Greuter

Zweifel

Guzman

et al. 2022

JCM

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Background: The outbreak of coronavirus disease 2019 (COVID-19) has been rapidly evolving, resulting in a pandemic, with 270,031,622 infections according to the World Health Organization. Patients suffering from COVID-19 have also been described to suffer from neurologic and coagulopathic symptoms apart from the better-known flu-like symptoms. Some studies showed that patients suffering from COVID-19 were likely to developed intracranial hemorrhages. To our knowledge, only a few studies have investigated postoperative complications in COVID-19-positive neurosurgical patients and investigated the perioperative complications, either thrombotic or hemorrhagic, in patients with SARS-CoV-2 undergoing a neurosurgical intervention. Methods: We conducted a retrospective cohort study including patients from March 2020 to March 2021 undergoing neurosurgical interventions and suffering from COVID-19. Our primary outcome parameter was a hemorrhagic or thrombotic complication within 30 days after surgery. These outcomes were compared to those for a COVID-19-negative cohort of patients using propensity score matching. Results: We included ten COVID-19-positive patients with a mean age of 56.00 (±14.91) years. Twelve postoperative complications occurred in five patients. Three thrombotic complications (30%) were observed, with two cerebral sinus vein thromboses and one pulmonary embolus. Two patients suffered from a postoperative hemorrhagic complication (20%). The mean postoperative GCS was 14.30 (±1.57). COVID-19-positive patients showed a significantly higher rate of overall postoperative complications ((6 (60.0%) vs. 10 (19.2%), p = 0.021), thrombotic complications (3 (30.0%) vs. 1 (1.9%), p = 0.009), and mortality (2 (20.0%) vs. 0 (0.0%), p = 0.021) compared to the matched cohort of COVID-19-negative patients, treated at our institute before the SARS-CoV-2 pandemic. Conclusion: Patients undergoing neurosurgical operations with concomitant COVID-19 infection have higher rates of perioperative complications.

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Section: Discussionmentioning

confidence: 76%

Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery

Greuter

Zweifel

Guzman

et al. 2022

JCM

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“…One previous report by Greco et al 8 , showed that the IMPROVE score was not an independent predictor of the need for intensification of treatment; however, it was a risk factor for mortality. The unexplained contradiction in the results of Greco et al, might be due to the retrospective design, the small sample (51 patients), and the lack of evaluation of the severity of illness in the included patients.…”

Section: Discussionmentioning

confidence: 87%

“…The IMPROVE score was then validated showing good ability to risk-stratify acutely ill medical patients for VTE 6 and Similar findings had been reported in hospitalized patients with COVID-19 7 . In a retrospective analysis, high IMPROVE score was reported to be an independent predictor for 30-days mortality in patients with COVID-19 with undifferentiated severity 8 . To the best of our knowledge, there is no reports of prospectively evaluating the ability of IMPROVE and IMPROVE-DD score to predict outcomes in patients with severe COVID-19.…”

Section: Introductionmentioning

confidence: 97%

Ability of IMPROVE and IMPROVE-DD scores to predict outcomes in patients with severe COVID-19: a prospective observational study

Helmy

Milad

Hasanin

et al. 2022

Sci Rep

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In this study we aimed to evaluate the ability of IMPROVE and IMPROVE-DD scores in predicting in-hospital mortality in patients with severe COVID-19. This prospective observational study included adult patients with severe COVID-19 within 12 h from admission. We recorded patients' demographic and laboratory data, Charlson comorbidity index (CCI), SpO2 at room air, acute physiology and chronic health evaluation II (APACHE II), IMPROVE score and IMPROVE-DD score. In-hospital mortality and incidence of clinical worsening (the need for invasive mechanical ventilation, vasopressors, renal replacement therapy) were recorded. Our outcomes included the ability of the IMPROVE and IMPROVE-DD to predict in-hospital mortality and clinical worsening using the area under receiver operating characteristic curve (AUC) analysis. Multivariate analysis was used to detect independent risk factors for the study outcomes. Eighty-nine patients were available for the final analysis. The IMPROVE and IMPROVE-DD score showed the highest ability for predicting in-hospital mortality (AUC [95% confidence intervals {CI}] 0.96 [0.90–0.99] and 0.96 [0.90–0.99], respectively) in comparison to other risk stratification tools (APACHE II, CCI, SpO2). The AUC (95% CI) for IMPROVE and IMPROVE-DD to predict clinical worsening were 0.80 (0.70–0.88) and 0.79 (0.69–0.87), respectively. Using multivariate analysis, IMPROVE-DD and SpO2 were the only predictors for in-hospital mortality and clinical worsening. In patients with severe COVID-19, high IMPROVE and IMOROVE-DD scores showed excellent ability to predict in-hospital mortality and clinical worsening. Independent risk factors for in-hospital mortality and clinical worsening were IMPROVE-DD and SpO2.

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“…The IMPROVE score, for instance, has been explored in this setting where it predicts poor survival, while no data were reported regarding thrombosis. 8 With the aim of building up a score to predict thrombosis, we performed a multicenter observational study in a cohort of patients affected by SARS-CoV-2, in whom the occurrence of intrahospital thrombotic events was monitored.…”

Section: Introductionmentioning

confidence: 99%

The ADA (Age-D-Dimer-Albumin) Score to Predict Thrombosis in SARS-CoV-2

et al. 2022

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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV2)-related pneumonia is associated with venous and arterial thrombosis . Aim of the study was to find-out a new score for predicting thrombosis in patients with SARS-CoV-2. Methods: We included a cohort of 674 patients affected by SARS-CoV-2, not requiring intensive care units, and followed-up during the hospitalization until discharge. Routinary analyses performed at in-hospital admission included also serum albumin and D-dimer while arterial and venous thromboses were the end-points of the study. Results: During the follow-up thrombotic events 110 were registered; patients with thrombotic events were older and had lower albumin and higher D-dimer, compared to thrombotic event-free ones. On multivariable logistic regression with step by stepwise procedure age, serum albumin, D-dimer, were independently associated with thrombotic events. The linear combination of age, D-dimer, albumin allowed to build-up the ADA score, whose AUC was 0.752 (95% CI, 0.708-0.795). ADA score was internally validated by bootstrap sampling procedure giving an AUC of 0.752 (95% CI: 0.708 - 0.794). Conclusions: Combination of age, D-dimer, albumin in the ADA score allows identifying SARS-CoV-2 patients at higher risk of thrombotic events.

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SARS-CoV-2 and Finding of Vein Thrombosis: Can IMPROVE and IMPROVEDD Scores Predict COVID-19 Outcomes?

Cited by 9 publications

References 0 publications

Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery

Perioperative Complications of Patients with SARS-CoV-2 Infection in Neurosurgery

Ability of IMPROVE and IMPROVE-DD scores to predict outcomes in patients with severe COVID-19: a prospective observational study

The ADA (Age-D-Dimer-Albumin) Score to Predict Thrombosis in SARS-CoV-2

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