UNIGE document Scientific Article
previous document  unige:26368  next document
add to browser collection

Prospective, multicenter validation of prediction scores for major bleeding in elderly patients with venous thromboembolism

Scherz, Nathalie
Méan, Marie
Jaeger, Kurt
Beer, Hans-Jürg
Frauchiger, Beat
show hidden authors show all authors [1 - 20]
Published in Journal of thrombosis and haemostasis. 2013, vol. 11, no. 3, p. 435-443
Abstract BACKGROUND: The Outpatient Bleeding Risk Index (OBRI) and the Kuijer, RIETE, and Kearon scores are clinical prognostic scores for bleeding in patients receiving oral anticoagulants for venous thromboembolism (VTE). We prospectively compared the performance of these scores in elderly patients with VTE. METHODS: In a prospective multicenter Swiss cohort study, we studied 663 patients aged ≥65 years with acute VTE. The outcome was a first major bleeding at 90 days. We classified patients into three categories of bleeding risk (low, intermediate, and high) according to each score and dichotomized patients as high vs. low or intermediate risk. We calculated the area under the receiver operating characteristic (ROC) curve, positive predictive values and likelihood ratios for each score. RESULTS: Overall, 28 out of 663 patients (4.2%, 95% confidence interval 2.8-6.0%) had a first major bleeding within 90 days. According to different scores, the rate of major bleeding varied from 1.9% to 2.1% in low-risk, from 4.2% to 5.0% in intermediate-risk, and from 3.1% to 6.6% in high-risk patients. The discriminative power of the scores was poor to moderate, with areas under the ROC curve ranging from 0.49 to 0.60 (P=0.21). The positive predictive values and positive likelihood ratios were low and varied from 3.1% to 6.6% and from 0.72 to 1.59, respectively. CONCLUSION: In elderly patients with VTE, existing bleeding risk scores do not have sufficient accuracy and power to discriminate between patients with VTE who are at high-risk of short-term major bleeding and those who are not. © 2012 International Society on Thrombosis and Haemostasis.
Keywords AnticoagulationBleedingElderly patientsVenous thromboembolism
PMID: 23279158
Full text
Article (Published version) (351 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research group La maladie thromboembolique veineuse (808)
(ISO format)
SCHERZ, Nathalie et al. Prospective, multicenter validation of prediction scores for major bleeding in elderly patients with venous thromboembolism. In: Journal of thrombosis and haemostasis, 2013, vol. 11, n° 3, p. 435-443. doi: 10.1111/jth.12111 https://archive-ouverte.unige.ch/unige:26368

496 hits

0 download


Deposited on : 2013-02-12

Export document
Format :
Citation style :