FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1672842893> ?p ?o ?g. }

• W1672842893 endingPage "231" @default.
• W1672842893 startingPage "231" @default.
• W1672842893 abstract "Abstract Introduction: Thrombotic thrombocytopenic purpura (TTP) is a hematologic emergency that requires the immediate initiation of therapy without access to the results of definitive testing and often in the setting of limited prior clinical experience. In this context, a simple, validated, and rapidly deployable diagnostic scoring system could be a powerful tool. Methods: We studied 214 consecutive adults admitted to 3 major teaching hospitals between 2004 and 2014 with thrombocytopenia (range: 5 to 149,000/μL) and schistocytes suspicious for TTP (derivation cohort). Twenty-nine different laboratory and clinical parameters were evaluated to identify those most highly associated with an ADAMTS13 activity level of ≤10%. Cutoffs for continuous variables were determined by generating receiver operator curves and identifying the cutoff point associated with the maximum Youden Index. Those parameters most associated with a low ADAMTS13 level by univariate analysis (P≤0.1) were included in a logistic regression to create a parsimonious predictive model. The resulting model was validated through a prospectively collected internal cohort (n=40) and an external cohort (n=147) drawn from a different academic medical center. Results: Four individual laboratory parameters (platelet count <30,000/μL, MCV <90fL, creatinine <2.0mg/dL, and INR <1.5), a combined laboratory parameter (evidence for hemolysis based on either a reticulocyte count >2.5%, an indirect bilirubin >2.0 mg/dL, or absent haptoglobin), and two historical features (no active cancer, no history of bone marrow or solid organ transplantation) were predictive of an ADAMTS13 activity of ≤10% in our logistic regression model. Based on similar odds ratio estimates, each factor was assigned a value of 1 point, with scores of 0-4 considered low risk, 5-6 intermediate, and 7 high. The derivation cohort (n=214) contained 62 cases of idiopathic TTP with low ADAMTS13 activity level. When applied against this cohort, the score effectively sorted patients according to ADAMTS13 level (See Table) and demonstrated an AUC of 0.96 (95% CI 0.92-0.98). An internally-collected prospective validation cohort (n=40) contained 6 cases of idiopathic TTP with low ADAMTS13 activity, and the score demonstrated an AUC of 0.96 (95% CI 0.84-1.00). For the second independent validation, an external cohort from a large academic healthcare system in the southeastern United States was used (n=147) that contained 69 cases of idiopathic TTP with low ADAMTS13 activity. When tested against this dataset, cases with scores falling in the low, intermediate, and high risk groups were respectively 4.3%, 56.8%, and 96.2% likely to have an ADAMTS13 activity level ≤10% (see Table). This corresponded to an AUC of 0.90 (95% CI 0.84-0.95). Scores corresponded to certain diagnoses, with 21/27 cases of DIC and 23/31 cases of drug-associated thrombotic microangiopathy (TMA) sorting to the low risk category. Scores were associated with one year survivals of 46.9%, 69.2%, and 96.9% for the low, intermediate, and high risk groups respectively (see Figure, p < 0.0001 by log-rank). Conclusions: A simple, validated clinical scoring system can assist in the early diagnosis of TTP by accurately identifying cases with a high likelihood of having severe ADAMTS13 deficiency. The word PLASMIC can be used to recall the 7 features of the score (platelets, lysis, active cancer, stem cell or solid organ transplant, MCV, INR, and creatinine). This scoring system also has the potential to provide accurate diagnostic and prognostic information for other TMAs. The ability to rapidly diagnose TTP with this approach would facilitate the initiation of appropriate therapy, while in low-risk cases clinicians could pursue alternative diagnoses with a high degree confidence. Table 1 Proportion ADAMTS13 ≤10% Derivation (%) Validation Internal (%) External (%) Risk Category Low (0-4) 0/84 (0) 0/22 (0) 2/47 (4.3) Intermediate (5-6) 25/77 (32.4) 3/15 (20) 42/74 (56.8) High (7) 37/39 (94.9) 3/3 (100) 25/26 (96.2) Figure 1 Figure 1. Disclosures Makar: Alexion Pharmaceutials: Research Funding." @default.
• W1672842893 created "2016-06-24" @default.
• W1672842893 creator A5008626205 @default.
• W1672842893 creator A5024470540 @default.
• W1672842893 creator A5032481180 @default.
• W1672842893 creator A5042640271 @default.
• W1672842893 creator A5051091978 @default.
• W1672842893 creator A5052649512 @default.
• W1672842893 creator A5054460243 @default.
• W1672842893 creator A5058609949 @default.
• W1672842893 creator A5059605240 @default.
• W1672842893 creator A5079461625 @default.
• W1672842893 date "2014-12-06" @default.
• W1672842893 modified "2023-10-01" @default.
• W1672842893 title "Derivation and Prospective Validation of a Predictive Score for the Rapid Diagnosis of Thrombotic Thrombocytopenic Purpura: The Plasmic Score" @default.
• W1672842893 doi "https://doi.org/10.1182/blood.v124.21.231.231" @default.
• W1672842893 hasPublicationYear "2014" @default.
• W1672842893 type Work @default.
• W1672842893 sameAs 1672842893 @default.
• W1672842893 citedByCount "16" @default.
• W1672842893 countsByYear W16728428932016 @default.
• W1672842893 countsByYear W16728428932017 @default.
• W1672842893 countsByYear W16728428932019 @default.
• W1672842893 countsByYear W16728428932020 @default.
• W1672842893 countsByYear W16728428932021 @default.
• W1672842893 countsByYear W16728428932023 @default.
• W1672842893 crossrefType "journal-article" @default.
• W1672842893 hasAuthorship W1672842893A5008626205 @default.
• W1672842893 hasAuthorship W1672842893A5024470540 @default.
• W1672842893 hasAuthorship W1672842893A5032481180 @default.
• W1672842893 hasAuthorship W1672842893A5042640271 @default.
• W1672842893 hasAuthorship W1672842893A5051091978 @default.
• W1672842893 hasAuthorship W1672842893A5052649512 @default.
• W1672842893 hasAuthorship W1672842893A5054460243 @default.
• W1672842893 hasAuthorship W1672842893A5058609949 @default.
• W1672842893 hasAuthorship W1672842893A5059605240 @default.
• W1672842893 hasAuthorship W1672842893A5079461625 @default.
• W1672842893 hasConcept C126322002 @default.
• W1672842893 hasConcept C141071460 @default.
• W1672842893 hasConcept C144301174 @default.
• W1672842893 hasConcept C151730666 @default.
• W1672842893 hasConcept C151956035 @default.
• W1672842893 hasConcept C188816634 @default.
• W1672842893 hasConcept C198433322 @default.
• W1672842893 hasConcept C2778585876 @default.
• W1672842893 hasConcept C2779343474 @default.
• W1672842893 hasConcept C2780921031 @default.
• W1672842893 hasConcept C2781127562 @default.
• W1672842893 hasConcept C38180746 @default.
• W1672842893 hasConcept C65245452 @default.
• W1672842893 hasConcept C71924100 @default.
• W1672842893 hasConcept C72563966 @default.
• W1672842893 hasConcept C86803240 @default.
• W1672842893 hasConcept C89560881 @default.
• W1672842893 hasConcept C90924648 @default.
• W1672842893 hasConceptScore W1672842893C126322002 @default.
• W1672842893 hasConceptScore W1672842893C141071460 @default.
• W1672842893 hasConceptScore W1672842893C144301174 @default.
• W1672842893 hasConceptScore W1672842893C151730666 @default.
• W1672842893 hasConceptScore W1672842893C151956035 @default.
• W1672842893 hasConceptScore W1672842893C188816634 @default.
• W1672842893 hasConceptScore W1672842893C198433322 @default.
• W1672842893 hasConceptScore W1672842893C2778585876 @default.
• W1672842893 hasConceptScore W1672842893C2779343474 @default.
• W1672842893 hasConceptScore W1672842893C2780921031 @default.
• W1672842893 hasConceptScore W1672842893C2781127562 @default.
• W1672842893 hasConceptScore W1672842893C38180746 @default.
• W1672842893 hasConceptScore W1672842893C65245452 @default.
• W1672842893 hasConceptScore W1672842893C71924100 @default.
• W1672842893 hasConceptScore W1672842893C72563966 @default.
• W1672842893 hasConceptScore W1672842893C86803240 @default.
• W1672842893 hasConceptScore W1672842893C89560881 @default.
• W1672842893 hasConceptScore W1672842893C90924648 @default.
• W1672842893 hasIssue "21" @default.
• W1672842893 hasLocation W16728428931 @default.
• W1672842893 hasOpenAccess W1672842893 @default.
• W1672842893 hasPrimaryLocation W16728428931 @default.
• W1672842893 hasRelatedWork W114643804 @default.
• W1672842893 hasRelatedWork W17016037 @default.
• W1672842893 hasRelatedWork W2008269539 @default.
• W1672842893 hasRelatedWork W2043277479 @default.
• W1672842893 hasRelatedWork W2157950179 @default.
• W1672842893 hasRelatedWork W2246395889 @default.
• W1672842893 hasRelatedWork W2429676791 @default.
• W1672842893 hasRelatedWork W3122465999 @default.
• W1672842893 hasRelatedWork W3150278892 @default.
• W1672842893 hasRelatedWork W3153473798 @default.
• W1672842893 hasVolume "124" @default.
• W1672842893 isParatext "false" @default.
• W1672842893 isRetracted "false" @default.
• W1672842893 magId "1672842893" @default.
• W1672842893 workType "article" @default.