Abstract Number: PB0917
Meeting: ISTH 2022 Congress
Background: Recurrent venous thromboembolism (VTE) occurs frequently in cancer patients despite curative anticoagulation. The Ottawa score was designed to stratify patients according to their risk of recurrent VTE within 6 months after starting anticoagulation.
Aims: To analyze the predictive value of the Ottawa risk score among cancer patients from the TROPIQUE study cohort.
Methods: TROPIQUE was a prospective multicenter observational cohort of adult cancer patients with newly diagnosed VTE treated with low molecular weight heparin (LMWH) for 6 months. For all patients included in the study, we retrospectively calculated the modified Ottawa score as follows: female sex, lung cancer, and prior history of VTE, each accounting for 1 point; breast cancer and cancer stage I + II each accounting for -1 point. Patients with an Ottawa score ≥ 1 were classified at high-risk for recurrent VTE. The primary endpoint was recurrent VTE within the first 6 months of anticoagulation. All clinical events were centrally adjudicated. The Fine-Gray competing risk model was used to take into account the competing risk of death.
Results: A total of 409 patients were analyzed on an intention-to-treat basis. At study entry, patients were aged 65.0±12.1 years. The majority of index VTE events were deep vein thrombosis (47.2%) or pulmonary embolism (35.5%). The main primary cancer site was gastrointestinal (24.4%), followed by lung (17.4%) and breast (15.9%), and 249 (60.9%) patients had metastatic disease. The modified Ottawa score was high (≥1) in 163 (39.9%) patients. The overall 6-month cumulative incidence of recurrent VTE was 6.2 % (95% CI: 4.0-9.5), and 6.6% (95% CI: 4.0-10.7) versus 5.7% (95%CI: 2.6-12.5) in the Ottawa low-intermediate and high-risk groups, respectively. The C-statistic value was 0.52 (95% CI: 0.46-0.58).
Conclusion(s): In this prospective cohort of cancer patients receiving LMWH for VTE, the Ottawa score failed to accurately predict the risk of recurrent VTE.
To cite this abstract in AMA style:Frere C, Debourdeau P, lamblin A, Cajfinger F, Falvo N, Benhamou Y, Sevestre M, Farge D. The Ottawa Score did not predict recurrent venous thromboembolism in the prospective TROPIQUE cohort study [abstract]. https://abstracts.isth.org/abstract/the-ottawa-score-did-not-predict-recurrent-venous-thromboembolism-in-the-prospective-tropique-cohort-study/. Accessed November 30, 2023.
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