Abstract

KEOKGALE, Tweedy; VAN BLYDENSTEIN, Sarah A.  and  KALLA, Ishmail S.. Evaluation of the modified Wells score in predicting venous thromboembolic disease in patients with tuberculosis or HIV in a South African setting. South. Afr. j. HIV med. (Online) [online]. 2022, vol.23, n.1, pp.1-11. ISSN 2078-6751.  http://dx.doi.org/10.4102/sajhivmed.v23i1.1349.

BACKGROUND: There is paucity of data on the modified Wells score (MWS) utility on patients with venous thromboembolism (VTE) in a South African setting where there is a high burden of HIV and tuberculosis (TB). This study analyses the performance of this score in HIV/TB-infected patients compared with non-infected patients OBJECTIVES: To assess the performance of the MWS as an additional risk factor for VTE in hospitalised patients with a high burden of HIV/TB infections METHOD: This study was a retrospective cross-sectional cohort analysis of the utility of the MWS in 156 HIV/TB-infected and non-infected adult patients diagnosed with VTE on compression ultrasonography (CUS) or computed tomography pulmonary angiography (CTPA) in a medical inpatient setting over six months. Patients with HIV and/or TB were assessed as having an additional risk factor (1 point for each), and this was compared with the MWS. A McNeymar's paired sample chi-squared test was used to compare the sensitivity of this score against the MWS RESULTS: Of the 156 patients with VTE who were enrolled, HIV was the commonest risk factor (42.31%) with TB accounting for 10.90% of cases. When the MWS adjusted for HIV/TB was used, the sensitivity increased from 25% to 100% for the HIV-/TB+ category, it increased from 77.36% to 98.11% in the HIV+/TB- category and it increased from 84.62% to 92.95% in the HIV+/TB+ category. These differences were statistically significant at P < 0.05 in all categories CONCLUSION: The MWS performs better when the infectivity of HIV/TB is included as an additional risk factor in the score

Keywords : modified Wells score; HIV; tuberculosis; pulmonary embolism; deep vein thrombosis.

        · text in English     · English ( pdf )