A validation and modification of PLASMIC score by adjusting the criteria of mean corpuscular volume and international normalized ratio.
J Clin Apher
; 38(5): 582-589, 2023 Oct.
Article
em En
| MEDLINE
| ID: mdl-37325919
ABSTRACT
BACKGROUND:
The PLASMIC score was developed for distinguishing thrombotic thrombocytopenic purpura (TTP) from other types of thrombotic microangiopathy. However, two components of the PLASMIC score, mean corpuscular volume (MCV) and international normalized ratio (INR), showed non-significant differences between TTP and non-TTP patients in previous validations. Here, we validate the PLASMIC score and aim to modify it by adjusting the criteria of MCV and INR. MATERIALS ANDMETHODS:
A retrospective validation of suspected TTP patients was performed by reviewing electronic medical records from two medical centers in Taiwan. The performance of different modified types of the PLASMIC score was carried out.RESULTS:
Among 50 patients included in the final analysis, 12 were diagnosed with TTP based on deficiency of ADAMTS13 activity and clinical judgement. When stratified by high (score ≥ 6) and low-intermediate risk (score < 6), the positive predictive value (PPV) of the PLASMIC score to predict TTP was 0.45 (95% confidence interval [CI] 0.29-0.61). The area under curve (AUC) was 0.70 (95% CI 0.56-0.82). When adjusting the criteria of the PLASMIC score from MCV < 90 fL to MCV ≥ 90 fL, the PPV increased to 0.57 (95% CI 0.37-0.75). The AUC was 0.75 (95% CI 0.61-0.87). When adjusting the INR from >1.5 to >1.1, the PPV increased to 0.56 (95% CI 0.39-0.71). The AUC was 0.81 (95% CI 0.68-0.90).CONCLUSION:
MCV ≥ 90 fL and/or INR > 1.1 might be suitable modifications for PLASMIC score but should be validated in a larger sample size.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Púrpura Trombocitopênica Trombótica
/
Microangiopatias Trombóticas
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Apher
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Taiwan