Evaluation of the modified Wells score in predicting venous thromboembolic disease in patients with tuberculosis or HIV in a South African setting

Southern African Journal of HIV Medicine

Field Value
Title Evaluation of the modified Wells score in predicting venous thromboembolic disease in patients with tuberculosis or HIV in a South African setting
Creator Keokgale, Tweedy van Blydenstein, Sarah A. Kalla, Ishmail S.
Subject Health Sciences; Medicine; Internal Medicine; Infectious diseases; Haematology modified Wells score; HIV; tuberculosis; pulmonary embolism; deep vein thrombosis
Description 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.
Publisher AOSIS
Contributor Chris Hani Baragwanath Academic Hospital Sebokeng Regional Hospital
Date 2022-03-23
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Retrospective cross sectional cohort analysis
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v23i1.1349
Source Southern African Journal of HIV Medicine; Vol 23, No 1 (2022); 11 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1349/2725 https://sajhivmed.org.za/index.php/hivmed/article/view/1349/2726 https://sajhivmed.org.za/index.php/hivmed/article/view/1349/2727 https://sajhivmed.org.za/index.php/hivmed/article/view/1349/2728
Coverage Nil Nil >=18; M+F; All
Rights Copyright (c) 2022 Tweedy Keokgale, Sarah Alexandra van Blydenstein, Ishmail Sikander Kalla https://creativecommons.org/licenses/by/4.0