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Validation of PLASMIC score and follow-up data in a cohort of patients with suspected microangiopathies from Southern Italy
Authors:Giovanni Luca Tiscia  Angelo Ostuni  Nicola Cascavilla  Filomena Cappucci  Potito Scalzulli  Cosima Battista  Antonio Abrescia  Filippo Aucella  Caterina Buquicchio  Maurizio Brigante  Giovanna D’Andrea  Bruno Di Paolo  Giulio Giordano  Barbara Infante  Silvia Piano  Prudenza Ranieri  Livio Tullo  Elvira Grandone
Affiliation:1.IRCCS “Casa Sollievo della Sofferenza”,San Giovanni Rotondo,Italy;2.Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari,Bari,Italy;3.Ospedale “Mons. Dimiccoli”,Barletta,Italy;4.Ospedale “A. Cardarelli”,Campobasso,Italy;5.Azienda Ospedaliero-Universitaria “Ospedali Riuniti”,Foggia,Italy;6.Ospedale “San Pio da Pietrelcina”,Vasto,Italy
Abstract:Severe ADAMTS13 deficiency (activity?PLASMIC score, has been developed to stratify acute patients, based on their risk of having a severe ADAMTS13 deficiency. We present the application of this score in a cohort of patients referred to our Center. From 2012 to 2017, 42 patients with suspected thrombotic microangiopathies from 6 Centers were referred to Hemostasis and Thrombosis Center of “Casa Sollievo della Sofferenza” Hospital/Research Institute for ADAMTS13 testing. For all patients, relevant medical and laboratory information were collected. To obtain the statistical measure of the discriminatory power of PLASMIC scoring system, the Area Under the Curve Receiver Operating Characteristic (AUC ROC) was calculated. We were able to calculate the PLASMIC score in 27 out of 42 patients; we found a good discrimination performance of the score with a resulting AUC value of 0.86 (95% CI 0.71–1.0; p?=?0.015). All patients but one with a high risk PLASMIC score (6–7) showed a severe deficiency. Among patients belonging to the intermediate risk (PLASMIC score 5) group, 2 showed normal ADAMTS13 activity and 2 levels below 10%. In none of the patients in the low risk group (PLASMIC score 0–4), a severe ADAMTS13 deficiency was found. Present results confirm and extend previous data regarding the predictive value of the PLASMIC score. Indeed, it shows a good diagnostic performance and can be useful for decision makers to properly and promptly define the better therapeutic approach.
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