A comprehensive model for assessing and classifying patients with thrombotic microangiopathy: the TMA-INSIGHT score

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Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorUniversidade Estadual de Campinas (UNICAMP)-
Autor(es): dc.contributorUniversidade de São Paulo (USP)-
Autor(es): dc.contributorHealth Technology Assessment Center of Hospital das Clínicas - HCFMB-
Autor(es): dc.creatorAddad, Vanessa Vilani-
Autor(es): dc.creatorPalma, Lilian Monteiro Pereira-
Autor(es): dc.creatorVaisbich, Maria Helena-
Autor(es): dc.creatorPacheco Barbosa, Abner Mácola-
Autor(es): dc.creatorda Rocha, Naila Camila-
Autor(es): dc.creatorde Almeida Cardoso, Marilia Mastrocolla-
Autor(es): dc.creatorde Almeida, Juliana Tereza Coneglian-
Autor(es): dc.creatorde Paula de Sordi, Monica Ap-
Autor(es): dc.creatorMachado-Rugolo, Juliana-
Autor(es): dc.creatorArantes, Lucas Frederico-
Autor(es): dc.creatorde Andrade, Luis Gustavo Modelli-
Data de aceite: dc.date.accessioned2025-08-21T20:43:46Z-
Data de disponibilização: dc.date.available2025-08-21T20:43:46Z-
Data de envio: dc.date.issued2025-04-29-
Data de envio: dc.date.issued2023-11-30-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1186/s12959-023-00564-6-
Fonte completa do material: dc.identifierhttps://hdl.handle.net/11449/309963-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/309963-
Descrição: dc.descriptionBackground: Thrombotic Microangiopathy (TMA) is a syndrome characterized by the presence of anemia, thrombocytopenia and organ damage and has multiple etiologies. The primary aim is to develop an algorithm to classify TMA (TMA-INSIGHT score). Methods: This was a single-center retrospective cohort study including hospitalized patients with TMA at a single center. We included all consecutive patients diagnosed with TMA between 2012 and 2021. TMA was defined based on the presence of anemia (hemoglobin level < 10 g/dL) and thrombocytopenia (platelet count < 150,000/µL), signs of hemolysis, and organ damage. We classified patients in eight categories: infections; Malignant Hypertension; Transplant; Malignancy; Pregnancy; Thrombotic Thrombocytopenic Purpura (TTP); Shiga toxin-mediated hemolytic uremic syndrome (STEC-SHU) and Complement Mediated TMA (aHUS). We fitted a model to classify patients using clinical characteristics, biochemical exams, and mean arterial pressure at presentation. Results: We retrospectively retrieved TMA phenotypes using automatic strategies in electronic health records in almost 10 years (n = 2407). Secondary TMA was found in 97.5% of the patients. Primary TMA was found in 2.47% of the patients (TTP and aHUS). The best model was LightGBM with accuracy of 0.979, and multiclass ROC-AUC of 0.966. The predictions had higher accuracy in most TMA classes, although the confidence was lower in aHUS and STEC-HUS cases. Conclusion: Secondary conditions were the most common etiologies of TMA. We retrieved comorbidities, associated conditions, and mean arterial pressure to fit a model to predict TMA and define TMA phenotypic characteristics. This is the first multiclass model to predict TMA including primary and secondary conditions.-
Descrição: dc.descriptionDepartment of Internal Medicine - UNESP Univ Estadual Paulista, Rubião Jr, s/n-
Descrição: dc.descriptionDepartment of Pediatrics Universidade Estadual de Campinas, R. Tessália Vieira de Camargo, 126 - Cidade Universitária-
Descrição: dc.descriptionPediatric Nephrology Service Child Institute University of São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 647, SP-
Descrição: dc.descriptionHealth Technology Assessment Center of Hospital das Clínicas - HCFMB-
Descrição: dc.descriptionDepartment of Internal Medicine - UNESP Univ Estadual Paulista, Rubião Jr, s/n-
Idioma: dc.languageen-
Relação: dc.relationThrombosis Journal-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectAtypical hemolytic uremic syndrome-
Palavras-chave: dc.subjectComplement mediated TMA-
Palavras-chave: dc.subjectShiga toxin-mediated hemolytic uremic syndrome-
Palavras-chave: dc.subjectThrombotic microangiopathy-
Palavras-chave: dc.subjectThrombotic Thrombocytopenic Purpura-
Título: dc.titleA comprehensive model for assessing and classifying patients with thrombotic microangiopathy: the TMA-INSIGHT score-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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