Performance of Diagnostic Scores in Thrombotic Microangiopathy Patients in the Intensive Care Unit: A Monocentric Study

• DOI: 10.1055/a-1378-3804
• Publication Date: 2021-01-29T23:56:35Z
• Authors: Eric Mariotte; Lara Zafrani; Jehane Fadlallah; Lionel Galicier; Etienne Ghrenassia; Lionel Kerhuel; Laure Calvet; Audrey De Jong; Virginie Lemiale; Sandrine Valade; Bérangère S. Joly; Alain Stepanian; Elie Azoulay; Michael Darmon
• Keywords: Thrombotic microangiopathy

Abstract Early thrombotic thrombocytopenic purpura (TTP) recognition is critical as this disease almost always lethal if not treated promptly with therapeutic plasma exchanges. Currently, ADAMTS13 (a disintegrin and metalloproteinase a thrombospondin type 1 motif, member 13) activity widely available in emergency, scores have been developed to help differentiating TTP from other microangiopathies (TMAs). The aim of work was study the accuracy these diagnostic intensive care unit (ICU) setting. Performance both Coppo PLASMIC studied cohort adult TMA patients requiring admission one university hospital ICU 2006 2017. Receiver operating characteristic (ROC) curves were established, confidence intervals area under curve (AUC) determined. Multivariate logistic regression analysis performed identify parameters specifically associated TTP, compare elaborate more accurate models. During period, 154 required admission, including 99 (64.2%) 55 (35.7%) non-TTP patients. AUC ROC predicting 0.86 (95% interval [CI]: 0.81–0.92) for score, 0.67 CI: 0.58–0.76) platelet count alone. Platelet ≤20 G/L, determined best cut-off rate thrombocytopenia, similarly score better than differentiate patients, using regression. In monocentric had limited performance diagnosis TTP. good but similar single highly discriminant item: G/L at admission.