Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Denmark.
Thromb Res. 2022 Apr;212:9-18. doi: 10.1016/j.thromres.2022.02.013. Epub 2022 Feb 17.
The Danish Comorbidity Index for Acute Myocardial Infarction (DANCAMI) was developed to predict one-year mortality after myocardial infarction. We validated DANCAMI in predicting one-year mortality after venous thromboembolism (VTE).
We identified all first-time VTE patients in Denmark during 2000-2015. Using Cox regression, we assessed the performance of DANCAMI to predict one-year all-cause mortality using Nagelkerke's R, Harrell's C-Statistic, the net reclassification index (NRI), and the integrated discrimination improvement (IDI). We compared the performance of DANCAMI with the Charlson Comorbidity Index (CCI) and the Elixhauser Comorbidity Index (ECI) and evaluated whether DANCAMI comorbidities not included in the CCI predicted one-year mortality. We stratified the analyses by type (deep vein thrombosis [DVT] and pulmonary embolism [PE]) and presence of provoking risk factors.
We identified 108,824 VTE patients of whom 20,649 (19%) died within one year. The R, C-Statistic, NRI, and IDI for DANCAMI were 0.35, 0.76, 0.63, and 0.098 for VTE overall; 0.43, 0.80, 0.70, and 0.105 for DVT; and 0.24, 0.71, 0.54, and 0.083 for PE. The R and C-Statistic for VTE overall were 0.35 and 0.76 for CCI and 0.33 and 0.75 for ECI. After adjusting for age, sex, and all CCI comorbidities, seven DANCAMI comorbidities, not included in the CCI, predicted increased mortality. DANCAMI performed better than the CCI and ECI in predicting mortality after provoked VTE, including provoked DVT and PE.
DANCAMI performed comparable to existing comorbidity indices in predicting one-year mortality after first-time VTE overall, but better after provoked VTE.
丹麦急性心肌梗死合并症指数（DANCAMI）旨在预测心肌梗死后一年的死亡率。我们对 DANCAMI 预测静脉血栓栓塞症（VTE）后一年死亡率的能力进行了验证。
我们在 2000 年至 2015 年期间确定了丹麦所有首次发生的 VTE 患者。我们使用 Cox 回归评估 DANCAMI 预测一年全因死亡率的性能，使用 Nagelkerke 的 R、Harrell 的 C-统计量、净重新分类指数（NRI）和综合判别改善（IDI）。我们比较了 DANCAMI 与 Charlson 合并症指数（CCI）和 Elixhauser 合并症指数（ECI）的性能，并评估了 DANCAMI 中不包含在 CCI 中的合并症是否预测一年死亡率。我们按类型（深静脉血栓形成 [DVT] 和肺栓塞 [PE]）和诱发危险因素的存在对分析进行分层。
我们确定了 108824 例 VTE 患者，其中 20649 例（19%）在一年内死亡。DANCAMI 的 R、C-统计量、NRI 和 IDI 为 VTE 总体为 0.35、0.76、0.63 和 0.098；DVT 为 0.43、0.80、0.70 和 0.105；PE 为 0.24、0.71、0.54 和 0.083。CCI 和 ECI 对 VTE 总体的 R 和 C-统计量分别为 0.35 和 0.76，0.33 和 0.75。在调整年龄、性别和所有 CCI 合并症后，7 种 DANCAMI 合并症（不包括在 CCI 中）预测死亡率增加。DANCAMI 在预测诱发 VTE 后，包括诱发的 DVT 和 PE，的死亡率方面优于 CCI 和 ECI。
DANCAMI 在预测首次 VTE 后一年的死亡率方面与现有的合并症指数表现相当，但在预测诱发 VTE 后更好。
