%0 Journal Article 
%A Paredes, Diana
%A Díaz-Pedroche, María del Carmen
%A Gómez Cuervo, Covadonga
%A Pérez-Jacoiste, Asunción
%A Valle, Reina
%A Blanco-Molina, Ángeles
%A Blanco-Molina, Ángeles
%A López Sáez, José Juan Bosco
%A Meireles, Jose
%A Sarlon-Bartoli, Gabrielle
%A Monreal, Manuel
%T Identifying patients with prostate cancer at increased risk for haematuria during anticoagulation for venous thromboembolism
%D 2023
%@ 0049-3848
%U http://hdl.handle.net/10498/38436
%X Background: Haematuria is a common complication in prostate cancer patients receiving anticoagulation for
venous thromboembolism (VTE). Early identification of at-risk patients might help to reduce its incidence and
severity.
Methods: We used data from the RIETE registry to develop a prognostic score for haematuria during the first year
of anticoagulation for VTE. The prognostic score was built using regression coefficients.
Results: From March 2001 through March 2021, 1934 patients with prostate cancer and acute VTE were enrolled.
Of these, 1034 (53 %) initially presented as pulmonary embolism and 900 (47 %) as isolated deep vein
thrombosis (DVT). During anticoagulation (median 181 days; inter-quartile range: 97–354), 99 patients (5.1 %)
developed haematuria (fatal 1, major 27, non-major 72). The incidence rate was: 8 events per 100 patient-years
(95%CI 6.5–9.7). Median time to haematuria was 53 days (IQR 4–134). On multivariable analysis, recent haematuria,
initial presentation as DVT, comorbidity, metastases, haemoglobin levels <11 g/dL, creatinine >1.2
mg/dL, and radiotherapy independently predicted the risk for haematuria. C-statistics was 0.71 (95%CI:
0.65–0.77). A cut-off of ≥1.5 points classified 312 patients (20 %) at high-risk and had the highest sensitivity (51
%; 95%CI: 39–62) and specificity (82 %; 95%CI: 79–83). Our score improved the performance and non-event net
reclassification index (NRI) of the RIETE score (c-statistics: 0.61; 95%CI: 0.54–0.68; NRI: 0.09) or VTE-BLEED
score (c-statistics: 0.64; 95%CI: 0.58–0.71; NRI: 0.76).
Conclusions: A prognostic score for haematuria during anticoagulation for VTE performed well in patients with
prostate cancer, and improved identification compared to other validated scores
%K Anticoagulation
%K Bleeding risk
%K Haematuria
%K Predictive score
%K Prostate cancer
%K Venous thromboembolism
%~ Universidad de Cádiz