Detecting optimal cut-off value of international normalized ration by receiver operator characteristic curve in diagnosis of hemorrhage in patients with nonvalvular atrial fibrillation receiving wafarin
10.3760/cma.j.issn.0254-9026.2010.11.015
- VernacularTitle:应用受试者工作曲线确定国际标准化比率诊断非瓣膜心房颤动患者华法林抗凝出血的最佳临界值
- Author:
Jianjun GAO
;
Xianzhong WANG
;
Delin LIU
;
Xiaolin ZHU
- Publication Type:Journal Article
- Keywords:
ROC curve;
Atrial fibrillation;
Warfarin;
International normalized ratio
- From:
Chinese Journal of Geriatrics
2010;29(11):924-926
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of international normalized ratio (INR) in predicting and diagnosing hemorrhagic events in patients with nonvalvular atrial fibrillation (NVAF)receiving wafarin, to determine the optimal cut-off value of INR for predicting hemorrhagic events by receiver operator characteristic (ROC) curve. Methods The data of 231 patients with NVAF receiving wafarin were retrospectively analyzed, including 93 patients with hemorrhagic events and 138cases without hemorrhagic events as control group. The PT and INR were detected by Sysmex CA-500 with Medcalc software plotting ROC curve. Results The area under the ROC curve for INR was 0. 822 (95%CI: 0. 717-0. 900), the analysis of ROC curve revealed the optimal cut-off value of INR was 2.71, which presented a sensitivity of 77.40% and a specificity of 78.30%. Conclusions Through evaluation by ROC curve, the new cut-off value provides substantial improvement in sensitivity, with an acceptable loss of specificity. The value on predicting hemorrhagic events is better, the discriminative power of INR between hemorrhagic events and nonhemorrhagic events is satisfactory. The cut-off value of INR can guide the clinical physicians to predict the risks of hemorrhagic and promote proper use of clinical medications.
