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

• Published in: Southern African journal of HIV medicine 2022, Vol.23 (1), p.1349-1349
• Main Authors: Keokgale, Tweedy, van Blydenstein, Sarah A., Kalla, Ishmail S.
• Format: Article
• Language: English
• Subjects: Age; Analysis; Angiography; Anticoagulants; Biology; Compression; Computed tomography; Cytomegalovirus; Deep vein thrombosis; Diagnostic imaging; Disease; Endothelium; Evidence-based medicine; Health aspects; Health Care Sciences & Services; Health Policy & Services; HIV; HIV (Viruses); HIV patients; Human immunodeficiency virus; Immunology; Infections; Infectivity; Medical research; Medicine, Experimental; modified Wells score; Mortality; Original Research; Patients; Proteins; Pulmonary embolism; Pulmonary embolisms; Risk factors; Statistical analysis; Thromboembolism; Thrombosis; Tuberculosis; Tumor necrosis factor-TNF
• ISSN: 1608-9693; 2078-6751; 2078-6751
• DOI: 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