Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores
The performance of validated bleeding risk scores in patients with venous thromboembolism (VTE) could be different depending on the time after index event or the site of bleeding. In this study we compared the "classic" Registro Informatizado de Enfermedad TromboEmbólica (RIETE) score and...
| Autores: | , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2021 |
| País: | España |
| Institución: | Universidad de Navarra |
| Repositorio: | Dadun. Depósito Académico Digital de la Universidad de Navarra |
| Idioma: | inglés |
| OAI Identifier: | oai:dadun.unav.edu:10171/115894 |
| Acceso en línea: | https://hdl.handle.net/10171/115894 |
| Access Level: | acceso abierto |
| Palabra clave: | Anticoagulation Bleeding Hemorrhage Score Venous thromboembolism |
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oai:dadun.unav.edu:10171/115894 |
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ES |
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España |
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Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores Lecumberri-Villamediana, R. (Ramón)|||/items/d804c113-76a8-47fb-85ad-0f01acbe605a Jiménez, L. (Laura)|||/items/7071fdc7-12bd-4f79-b998-c54f0618b22f Ruiz-Artacho, P.C. (Pedro Celso)|||/items/cdfaa5d7-8863-4e9a-b93a-d7e78096c087 Nieto, J.A. (José Antonio)|||/items/86b9cf34-8abb-4e53-ac9f-00d4df19eeba Ruiz-Giménez, N. (Nuria)|||/items/f552baf1-15a9-485a-ae55-6b6d92ac725b Visonà, A. (Adriana)|||/items/077bba31-16c7-45ae-a488-383c971dd292 Skride, A. (Andris)|||/items/c01f6245-26c4-4792-944c-0f0e1833576f Moustafa, F. (Fares)|||/items/1af9a0c2-3abe-4369-968c-ce9c164a19a5 Trujillo-Santos, J. (Javier)|||/items/9dc5c758-9433-4009-98c8-584348188760 Monreal, M. (Manuel)|||/items/c81a51a7-2e8d-4ae5-a9b1-e1b8b6d72031 Anticoagulation Bleeding Hemorrhage Score Venous thromboembolism The performance of validated bleeding risk scores in patients with venous thromboembolism (VTE) could be different depending on the time after index event or the site of bleeding. In this study we compared the "classic" Registro Informatizado de Enfermedad TromboEmbólica (RIETE) score and the more recently developed VTE-BLEED score for the prediction of major bleeding in patients under anticoagulant therapy in different time intervals after VTE diagnosis. Out of 82,239 patients with acute VTE, the proportion of high-risk patients according to the RIETE and VTE-BLEED scores was 7.1 and 62.3%, respectively. The performance of both scores across the different study periods (first 30 days after VTE diagnosis, days 31-90, days 91-180, and days 181-360) was similar, with areas under the receiving operating characteristics (ROC) curve (AUC) ranging between 0.69 and 0.72. However, the positive predictive values were low, ranging between 0.6 and 3.9 (better for early major bleeding than for later periods). A sensitivity analysis limited to patients with unprovoked VTE showed comparable results. Both scores showed a trend toward a better prediction of extracranial than intracranial major bleeding, the RIETE score resulting more useful for early extracranial bleeding and the VTE-BLEED for late intracranial hemorrhages. Our study reveals that the usefulness of available bleeding scores may vary depending on the characteristics of the patient population and the time frame evaluated. Dynamic scores could be more useful for this purpose. Thieme Group https://hdl.handle.net/10171/115894 |
| title |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| spellingShingle |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores Lecumberri-Villamediana, R. (Ramón)|||/items/d804c113-76a8-47fb-85ad-0f01acbe605a Anticoagulation Bleeding Hemorrhage Score Venous thromboembolism |
| title_short |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| title_full |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| title_fullStr |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| title_full_unstemmed |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| title_sort |
Prediction of major bleeding in anticoagulated patients for venous thromboembolism: Comparison of the RIETE and the VTE-BLEED Scores |
| author |
Lecumberri-Villamediana, R. (Ramón)|||/items/d804c113-76a8-47fb-85ad-0f01acbe605a |
| author_facet |
Lecumberri-Villamediana, R. (Ramón)|||/items/d804c113-76a8-47fb-85ad-0f01acbe605a Jiménez, L. (Laura)|||/items/7071fdc7-12bd-4f79-b998-c54f0618b22f Ruiz-Artacho, P.C. (Pedro Celso)|||/items/cdfaa5d7-8863-4e9a-b93a-d7e78096c087 Nieto, J.A. (José Antonio)|||/items/86b9cf34-8abb-4e53-ac9f-00d4df19eeba Ruiz-Giménez, N. (Nuria)|||/items/f552baf1-15a9-485a-ae55-6b6d92ac725b Visonà, A. (Adriana)|||/items/077bba31-16c7-45ae-a488-383c971dd292 Skride, A. (Andris)|||/items/c01f6245-26c4-4792-944c-0f0e1833576f Moustafa, F. (Fares)|||/items/1af9a0c2-3abe-4369-968c-ce9c164a19a5 Trujillo-Santos, J. (Javier)|||/items/9dc5c758-9433-4009-98c8-584348188760 Monreal, M. (Manuel)|||/items/c81a51a7-2e8d-4ae5-a9b1-e1b8b6d72031 |
| author_role |
author |
| author2 |
Jiménez, L. (Laura)|||/items/7071fdc7-12bd-4f79-b998-c54f0618b22f Ruiz-Artacho, P.C. (Pedro Celso)|||/items/cdfaa5d7-8863-4e9a-b93a-d7e78096c087 Nieto, J.A. (José Antonio)|||/items/86b9cf34-8abb-4e53-ac9f-00d4df19eeba Ruiz-Giménez, N. (Nuria)|||/items/f552baf1-15a9-485a-ae55-6b6d92ac725b Visonà, A. (Adriana)|||/items/077bba31-16c7-45ae-a488-383c971dd292 Skride, A. (Andris)|||/items/c01f6245-26c4-4792-944c-0f0e1833576f Moustafa, F. (Fares)|||/items/1af9a0c2-3abe-4369-968c-ce9c164a19a5 Trujillo-Santos, J. (Javier)|||/items/9dc5c758-9433-4009-98c8-584348188760 Monreal, M. (Manuel)|||/items/c81a51a7-2e8d-4ae5-a9b1-e1b8b6d72031 |
| author2_role |
author author author author author author author author author |
| topic |
Anticoagulation Bleeding Hemorrhage Score Venous thromboembolism |
| topic_facet |
Anticoagulation Bleeding Hemorrhage Score Venous thromboembolism |
| description |
The performance of validated bleeding risk scores in patients with venous thromboembolism (VTE) could be different depending on the time after index event or the site of bleeding. In this study we compared the "classic" Registro Informatizado de Enfermedad TromboEmbólica (RIETE) score and the more recently developed VTE-BLEED score for the prediction of major bleeding in patients under anticoagulant therapy in different time intervals after VTE diagnosis. Out of 82,239 patients with acute VTE, the proportion of high-risk patients according to the RIETE and VTE-BLEED scores was 7.1 and 62.3%, respectively. The performance of both scores across the different study periods (first 30 days after VTE diagnosis, days 31-90, days 91-180, and days 181-360) was similar, with areas under the receiving operating characteristics (ROC) curve (AUC) ranging between 0.69 and 0.72. However, the positive predictive values were low, ranging between 0.6 and 3.9 (better for early major bleeding than for later periods). A sensitivity analysis limited to patients with unprovoked VTE showed comparable results. Both scores showed a trend toward a better prediction of extracranial than intracranial major bleeding, the RIETE score resulting more useful for early extracranial bleeding and the VTE-BLEED for late intracranial hemorrhages. Our study reveals that the usefulness of available bleeding scores may vary depending on the characteristics of the patient population and the time frame evaluated. Dynamic scores could be more useful for this purpose. |
| publishDate |
2021 |
| format |
article |
| url |
https://hdl.handle.net/10171/115894 |
| language |
eng |
| eu_rights_str_mv |
openAccess |
| publisher |
Thieme Group |
| institution |
Universidad de Navarra |
| collection |
Dadun. Depósito Académico Digital de la Universidad de Navarra |
| reponame_str |
Dadun. Depósito Académico Digital de la Universidad de Navarra |
| instname_str |
Universidad de Navarra |
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1878437556767424513 |
| publishDateSort |
2021 |
| author_browse |
Jiménez, L. (Laura)|||/items/7071fdc7-12bd-4f79-b998-c54f0618b22f Lecumberri-Villamediana, R. (Ramón)|||/items/d804c113-76a8-47fb-85ad-0f01acbe605a Monreal, M. (Manuel)|||/items/c81a51a7-2e8d-4ae5-a9b1-e1b8b6d72031 Moustafa, F. (Fares)|||/items/1af9a0c2-3abe-4369-968c-ce9c164a19a5 Nieto, J.A. (José Antonio)|||/items/86b9cf34-8abb-4e53-ac9f-00d4df19eeba Ruiz-Artacho, P.C. (Pedro Celso)|||/items/cdfaa5d7-8863-4e9a-b93a-d7e78096c087 Ruiz-Giménez, N. (Nuria)|||/items/f552baf1-15a9-485a-ae55-6b6d92ac725b Skride, A. (Andris)|||/items/c01f6245-26c4-4792-944c-0f0e1833576f Trujillo-Santos, J. (Javier)|||/items/9dc5c758-9433-4009-98c8-584348188760 Visonà, A. (Adriana)|||/items/077bba31-16c7-45ae-a488-383c971dd292 |
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Thieme Group |
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6,9303427 |