Ruiz-Gimenez et al developed a simple score for identifying a patient at risk for major bleeding associated with anticoagulation therapy for acute venous thromboembolism. The authors are participating in the RIETE Registry (Spain, Italy, France, Argentina, Israel)..
Patient selection: acute venous thromboembolism with anticoagulation therapy (initially LMW or unfractioning heparin, long-term LMWH or anti-vitamin K drug)
Outcome: bleeding within 3 months of starting anticoagulation therapy.
Parameters:
(1) age in years
(2) history of recent major bleeding
(3) serum creatinine in mg/dL
(4) anemia
(5) cancer
(6) clinically overt pulmonary embolism (PE)
|
Parameter |
Finding |
Points |
|
age in years |
<= 75 years |
0 |
|
|
> 75 years |
1 |
|
history of recent major bleeding |
no |
0 |
|
|
yes |
2 |
|
serum creatinine |
<= 1.2 mg/dL |
0 |
|
|
> 1.2 mg/dL |
1.5 |
|
anemia |
no |
0 |
|
|
yes |
1.5 |
|
cancer |
no |
0 |
|
|
yes |
1 |
|
clinically over PE |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the risk of major bleeding.
|
Score |
Risk Group |
Major Bleeding |
|
0 |
low |
0.1 to 0.3% |
|
1 to 4 |
intermediate |
2.6 to 2.8% |
|
5 to 8 |
high |
6.2 to 7.3% |
where:
• Patients with a score of 7 or 8 had a 20% chance of a major bleed (Table 4).
Purpose: To identify a patient at risk for major bleeding associated with anticoagulation therapy for acute thromboembolism based on date from the RIETE registry.
Specialty: Hematology Oncology, Clinical Laboratory, Pharmacology, clinical
Objective: complications
ICD-10: I80, I81, I82,
