Prediction of bleeding events using the VTE‑BLEED risk score in patients with venous thromboembolism receiving anticoagulant therapy (Review)

Bădescu, Magda; Ciocoiu, Manuela; Bădulescu, Oana Viola; Vladeanu, Maria-Cristina; Bojan, Iris Bararu; Vlad, Cristiana-Elena; Rezuş, Ciprian

doi:10.3892/etm.2021.10779

Cited by 9 publications

(6 citation statements)

References 40 publications

(45 reference statements)

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“…Assessing the thrombotic burden in patients with active Ca, referring to those who have been diagnosed with a current or recent malignancy, those with metastatic disease, or those who are receiving anticancer treatment, remains a challenge, as patients with active Ca may experience thromboembolic and bleeding complications ( 2 ). An individualized assessment of every patient's profile is therefore required ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis of cancer‑associated venous thromboembolism with low‑molecular‑weight heparin‑tinzaparin: Real world evidence

et al. 2022

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Thromboprophylaxis, as a preventive measure for cancer-associated thrombosis (CAT), may be beneficial for patients with active cancer and high-risk for thrombosis. The present post hoc analysis include a total of 407 patients enrolled in the Greek Management of Thrombosis study, who received thromboprophylaxis with tinzaparin. The objectives of the present analysis were: i) To obtain sufficient evidence for the administration of prophylaxis in patients with active cancer, irrespective of Khorana risk assessment model score; ii) to identify the selection criteria for both dose and duration of tinzaparin; and iii) to evaluate the efficacy and safety of tinzaparin administered for CAT prophylaxis. The main tumor types for the patients included in the present study were as follows: Lung (25.1%), pancreatic (14.3%), breast (9.1%), stomach (8.4%), colorectal (7.9%) and ovarian (7.6%). Furthermore, metastatic disease was observed in 69.5% of the patients. High thrombotic burden agents (HTBAs) were administered to 66.3% of the patients, and 17.4% received erythropoietin. A total of 43.7% of the patients exhibited a Khorana score <2. The results of the present study demonstrated that both the presence of metastatic disease and the use of HTBAs seemed to influence oncologists' decisions for the use of thromboprophylaxis in patients with active cancer, regardless of Khorana score. Tinzaparin, in dose expressed in the standard notation for heparins, i.e., anti-Xa factor international units (Anti-Xa IU), was administered at an intermediate dose (InterD; 8,000-12,000 Anti-Xa IU; once daily) to 52.4% of patients, while the remaining patients received a prophylactic dose (ProD; ≤4,500 Anti-Xa IU; once daily). The average duration of thromoprophylaxis was 5 months. Furthermore, a total of 14 (3.4%) thrombotic events and 6 (1.5%) minor bleeding events were recorded. A total of four thrombotic events were observed following an InterD treatment of tinzaparin, while 10 thrombotic events were observed following ProD treatment. The present study also demonstrated that an InterD of tinzaparin was administered more frequently to patients

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Section: Introductionmentioning

confidence: 99%

Prophylaxis of cancer‑associated venous thromboembolism with low‑molecular‑weight heparin‑tinzaparin: Real world evidence

et al. 2022

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“…In addition, part of the protocol is to assess the risk of bleeding in the patient. For this purpose, we used the VTE-BLEED score ( 11 ), a clinical tool developed to assess the risk of bleeding in patients receiving anticoagulant therapy for the first time. Unlike the HAS-BLED clinical tool, which is most often used in clinical practice, the VTE-BLEED score was designed and subsequently validated in the group of patients with venous thromboembolic disease, while the HAS-BLED score was validated for the group of patients with nonvalvular atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

Outpatient treatment of pulmonary embolism – a single-center experience

Hamzić

2022

ACC

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Background: Pulmonary embolism (PE) is a common diagnosis in an emergency department. It also represents a large share of patients admitted to hospital wards. Patients with PE can be risk-stratified and discharged early from the emergency department. This results in better availability of hospital beds for other patients and a significant reduction of treatment costs for the healthcare system. This paper aims to describe the protocols used in our emergency department, with special emphasis on risk stratification, for adverse events and bleeding risk, treatment strategies, and outcomes for this type of protocol.Materials and methods: This paper is a retrospective analysis of patients discharged from the emergency department in a of two-year period (2020-2021) with a low-risk pulmonary embolism.Results: We have included in this study 42 patients discharged after a short-term observation from the emergency department (<24h) or short-term hospitalization; <24h). Ninety-one percent of patients were discharged with direct oral anticoagulant as a treatment for PE. We did not notice any adverse events (hemorrhage, progression of PE, or major cardiovascular issues).Conclusion: In the cohort of patients with PE, early discharge and outpatient treatment was safe and effective, with lower healthcare costs and almost no adverse events for patients

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“…Bleeding risk scores for VTE patients on anticoagulation have been developed (►Table 3) but have been poorly validated and do not provide meaningful guidance in everyday clinical practice. 56,57 Therefore, as prospective management studies for VTE patients are currently lacking, a high bleeding score should not be used as a justification to withhold anticoagulation from patients with acute VTE, which is a clear indication for anticoagulation.…”

Section: Risk Of Major Bleedingmentioning

confidence: 99%

Management of Deep Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline

Linnemann,

Beyer-Westendorf,

Espinola-Klein

et al. 2024

Hamostaseologie

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Deep vein thrombosis (DVT) and pulmonary embolism (PE) are the most common manifestations of venous thromboembolism (VTE). Most DVTs affect the lower-extremity veins. Since the symptoms of DVT are non-specific, a prompt and standardised diagnostic work-up is essential to minimise the risk of PE in the acute phase and to prevent thrombosis progression, post-thrombotic syndrome and VTE recurrence in the long-term. Only recently, the AWMF S2k guidelines on Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism have been revised. In the present article, we summarize current evidence and guideline recommendations focusing on lower-extremity DVT (LEDVT). Depending on whether the diagnostic work-up is performed by a specialist in vascular medicine or by a primary care physician, different diagnostic algorithms are presented that combine clinical probability, D-dimer testing and diagnostic imaging. The diagnosis of ipsilateral recurrent DVT poses a particular challenge and is presented in a separate algorithm. Anticoagulant therapy is an essential part of therapy, with current guidelines clearly favouring regimens based on direct oral anticoagulants over the traditional sequential therapy of parenteral anticoagulants and vitamin K antagonists. For most DVTs, a duration of therapeutic-dose anticoagulation of at least 3 to 6 months is considered sufficient, and this raises the question of the risk of VTE recurrence after discontinuation of anticoagulation and the need for secondary prophylaxis in the long-term. Depending on the circumstances and trigger factors that have contributed to the occurrence of DVT, management strategies are presented that allow decision-making taking into account the individual bleeding risk and patient's preferences.

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Prediction of bleeding events using the VTE‑BLEED risk score in patients with venous thromboembolism receiving anticoagulant therapy (Review)

Cited by 9 publications

References 40 publications

Prophylaxis of cancer‑associated venous thromboembolism with low‑molecular‑weight heparin‑tinzaparin: Real world evidence

Prophylaxis of cancer‑associated venous thromboembolism with low‑molecular‑weight heparin‑tinzaparin: Real world evidence

Outpatient treatment of pulmonary embolism – a single-center experience

Management of Deep Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline

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