Predictive Score of Nieto et al for Fatal Bleeding During Anticoagulant Therapy for Venous Thromboembolism

Description

Nieto et al developed a simple score for predicting the risk of fatal bleeding during anticoagulant therapy for venous thromboembolism. These can help to identify a patient who may benefit from more aggressive management. The authors are RIETE (Registro Informatizado de la Enfermeded TromboEmbolica) investigators from multiple hospitals in Spain.

Patient selection: anticoagulation for venous thromboembolism

Outcome: fatal bleeding

Parameters:

(1) age in years

(2) recent major bleeding

(3) immobility >= 4 days

(4) metastatic cancer

(5) anemia

(6) platelet count

(7) prothrombin time

(8) creatinine clearance in mL per minute

(9) distal deep vein thrombosis (DVT)

Parameter	Finding	Points
age in years	<= 75 years of age	0
	> 75 years of age	1
recent major bleeding	no	0
	yes	1.5
immobility >= 4 days	no	0
	yes	1
metastatic cancer	no	0
	yes	2
anemia	no	0
	yes	1
platelet count	>= 100,000 per µL	0
	< 100,000 per µL	1
prothrombin time	normal	0
	abnormal	1
creatinine clearance	>= 30 ml per min	0
	< 30 mL per mion	1
distal deep vein thrombosis	no	0
	yes	-1

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: -1

• maximum score: 9.5

• The higher the score the greater the risk of fatal bleeding.

Score	Risk of Fatal Bleeding
< 1.5	0.2%
1.5 to 4	1.1%
> 4	4.2%

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Predictive Score of Nieto et al for Fatal Bleeding During Anticoagulant Therapy for Venous Thromboembolism

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