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Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry

RUIZ-GIMENEZ, Nuria ; SUAREZ, Carmen ; GONZALEZ, Rocio ; NIETO, José Antonio ; TODOLI, José Antonio ; SAMPERIZ, Angel Luis ; MONREAL, Manuel

Thrombosis and haemostasis, 2008-07, Vol.100 (1), p.26-31 [Periódico revisado por pares]

Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften

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Título:
Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry
Autor: RUIZ-GIMENEZ, Nuria ; SUAREZ, Carmen ; GONZALEZ, Rocio ; NIETO, José Antonio ; TODOLI, José Antonio ; SAMPERIZ, Angel Luis ; MONREAL, Manuel
Assuntos: Acute Disease ; Age Factors ; Aged ; Aged, 80 and over ; Anemia ; Anemia - complications ; Anticoagulants ; Anticoagulants - adverse effects ; Argentina ; Argentina - epidemiology ; Biological and medical sciences ; bleeding complications ; Blood Coagulation, Fibrinolysis and Cellular Haemostasis ; Blood coagulation. Blood cells ; Creatinine ; Creatinine - blood ; Europe ; Europe - epidemiology ; Female ; Fundamental and applied biological sciences. Psychology ; Hematologic and hematopoietic diseases ; Hemorrhage ; Hemorrhage - blood ; Hemorrhage - chemically induced ; Hemorrhage - epidemiology ; Humans ; Incidence ; Israel ; Israel - epidemiology ; Life Sciences ; Likelihood Functions ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Molecular and cellular biology ; Patient Selection ; Pharmaceutical sciences ; Pharmacology ; Platelet diseases and coagulopathies ; Prediction ; Prospective Studies ; Pulmonary Embolism ; Pulmonary Embolism - complications ; Registries ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Venous Thromboembolism ; Venous Thromboembolism - blood ; Venous Thromboembolism - drug therapy ; Venous Thromboembolism - epidemiology
É parte de: Thrombosis and haemostasis, 2008-07, Vol.100 (1), p.26-31
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-News-2
ObjectType-Feature-3
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Descrição: Summary A score that can accurately determine the risk of major bleeding during anticoagulant therapy may help to make decisions on anticoagulant use. RIETE is an ongoing registry of consecutive patients with acute venous thromboembolism (VTE). We composed a score to predict the risk for major bleeding within three months of anticoagulant therapy. Of 19,274 patients enrolled, 13,057 (67%) were randomly assigned to the derivation sample, 6,572 to the validation sample. In the derivation sample 314 (2.4%) patients bled (fatal bleeding, 105). On multivariate analysis, age >75 years, recent bleeding, cancer, creatinine levels >1.2 mg/dl, anemia, or pulmonary embolism at baseline were independently associated with an increased risk for major bleeding. A score was composed assigning 2 points to recent bleeding, 1.5 to abnormal creatinine levels or anemia, 1 point to the remaining variables. In the derivation sample 2,654 (20%) patients scored 0 points (low risk); 9,645 (74%) 1–4 points (intermediate); 758 (5.8%) >4 points (high risk). The incidences of major bleeding were: 0.3% (95% confidence interval [CI]: 0.1–0.6), 2.6% (95% CI: 2.3–2.9), and 7.3% (95% CI: 5.6–9.3), respectively. The likelihood ratio test was:0.14 (95% CI:0.07–0.27) for patients at low risk;2.96 (95% CI:2.18–4.02) for those at high risk. In the validation sample the incidence of major bleeding was:0.1%,2.8%,and 6.2%,respectively. In conclusion, a risk score based on six variables documented at entry can identify VTE patients at low, intermediate, or high risk for major bleeding during the first three months of therapy.
Editor: Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften
Idioma: Inglês

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Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry

RUIZ-GIMENEZ, Nuria ; SUAREZ, Carmen ; GONZALEZ, Rocio ; NIETO, José Antonio ; TODOLI, José Antonio ; SAMPERIZ, Angel Luis ; MONREAL, Manuel

Stuttgart: Schattauer Verlag für Medizin und Naturwissenschaften

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