Abstract
Outpatient treatment of acute venous thromboembolism (VTE) requires the selection of patients with a low risk of bleeding during the first few weeks of anticoagulation. The accuracy of four systems, originally derived for predicting bleeding in VTE treated with vitamin K antagonists (VKAs), was assessed in VTE patients treated with rivaroxaban. All patients treated with rivaroxaban in the multinational EINSTEIN deep vein thrombosis (DVT) and pulmonary embolism (PE) trials were included. Major bleeding was defined as ≥2 g/dL drop in hemoglobin or ≥2-unit blood transfusion, bleeding in critical area, or bleeding contributing to death. The authors examined the incidence of major bleeding in patients with low-risk assignment by the systems of Ruiz-Gimenez et al. (score = 0 to 1), Beyth et al. (score = 0), Kuijer et al. (score = 0), and Landefeld and Goldman. (score = 0). For clinical relevance, the definition of low risk for all scores except Kuijer includes all patients < 65 years with no prior bleeding history and no comorbid conditions (current cancer, renal insufficiency, diabetes mellitus, anemia, prior stroke, or myocardial infarction). A total of 4,130 patients (1,731 with DVT only, 2,399 with PE with or without DVT) were tr...Continue Reading
References
Aug 1, 1989·The American Journal of Medicine·C S Landefeld, L Goldman
Sep 4, 1998·The American Journal of Medicine·R J BeythC S Landefeld
Mar 13, 1999·Archives of Internal Medicine·P M KuijerH R Büller
Apr 22, 2005·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Jul 10, 2008·Thrombosis and Haemostasis·Nuria Ruíz-GiménezUNKNOWN RIETE Investigators
Dec 7, 2010·The New England Journal of Medicine·Rupert BauersachsSebastian Schellong
Feb 1, 2012·Journal of Thrombosis and Haemostasis : JTH·I TzoranUNKNOWN RIETE Investigators
Mar 28, 2012·The New England Journal of Medicine·Harry R BüllerAnnelise Segers
Sep 5, 2012·Annals of Emergency Medicine·David R VinsonDonald M Yealy
Sep 17, 2013·Thrombosis Research·Siavash PiranMarc Carrier
Sep 24, 2013·Thrombosis Journal·Martin H PrinsUNKNOWN EINSTEIN Investigators
May 23, 2014·Thorax·Christopher KabrhelYuchiao Chang
Feb 20, 2015·Annals of the American Thoracic Society·David R VinsonUNKNOWN Kaiser Permanente Clinical Research on Emergency Services and Treatment (CREST) Network
Jun 27, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Daren M BeamJeffrey A Kline
Citations
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Apr 20, 2018·American Journal of Respiratory and Critical Care Medicine·Parth M Rali, Gerard J Criner
Jan 18, 2018·Pediatric Emergency Care·Julieta WeirtheinMiguel Glatstein
Jan 18, 2020·Blood·Frederikus A Klok, Menno V Huisman
Aug 4, 2020·Vascular and Endovascular Surgery·Chong LiMikel Sadek
Jun 29, 2017·Internal and Emergency Medicine·Francesco Dentali, Chiara Fantoni
Sep 11, 2020·The Annals of Pharmacotherapy·Adesola AdedejiJustin P Reinert
Oct 3, 2020·BMJ Open·Jeffrey KlineChristopher Willoughby
Feb 25, 2021·Hämostaseologie·Stephan Nopp, Cihan Ay
Dec 11, 2020·International Journal of Cardiology·Karsten KellerMir A Ostad
Apr 13, 2021·Postgraduate Medicine·William B Stubblefield, Jeffrey A Kline
May 11, 2021·Journal of Pharmacy Practice·Shaina E MuscoJill Gossard
Jun 12, 2021·Thrombosis Research·Justine PagenhardtJeffrey Kline
Jun 22, 2021·Circulation. Cardiovascular Quality and Outcomes·Jeffrey A KlineChristopher B Willoughby