The predictive ability of bleeding risk stratification models in very old patients on vitamin K antagonist treatment for venous thromboembolism: results of the prospective collaborative EPICA study: reply

Poli, Daniela; Antonucci, Emilia; Testa, Sophie; Cosmi, Benilde; Palareti, Gualtiero; Ageno, Walter

doi:10.1111/jth.12502

Cited by 1 publication

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“…23,24 Poli et al found a low C-statistic of 0.55 in elderly patients (i.e., age > 80 years) with VKA use. 25 Similar to our work, Kooiman et al recently showed that a HAS-BLED score of !3 is a strong predictor of major bleedings during VKA treatment for acute VTE in the first 6 months, despite a low sensitivity of 54.6%. They recommended that patients should be regarded as high risk by a cutoff of 3 points or higher, leading to a lower specificity (87.3%) on one hand, while avoiding missing a not negligible proportion of major bleeding events on the other.…”

Section: Discussionsupporting

confidence: 89%

Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

Rief

Raggam

Hafner

et al. 2017

Semin Thromb Hemost

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The aim of this study was prospective evaluation of the performance of the HAS-BLED score in predicting major bleeding complications in a real-world outpatient cohort, during long-term anticoagulation for venous thromboembolism (VTE), treated with a broad spectrum of anticoagulants. We analyzed 111 outpatients objectively diagnosed with VTE and treated long-term with various anticoagulants. Patients were grouped in three cohorts based on the anticoagulant regimen. Calculation of the HAS-BLED score and documentation of bleeding events were performed every 6 months for 1 year. Patients with a HAS-BLED score ≥ 3 had an increased risk for major bleeding events (odds ratio [OR]: 13.05, 95% confidence interval [CI]: 0.96-692.58, = 0.028) and a trend to higher risk for minor bleeding events as well (OR: 2.25, 95% CI: 0.87-5.85, = 0.091) when compared with patients with a HAS-BLED score < 3.This indicates that a HAS-BLED score ≥ 3 allows for identification of patients with VTE on long-term anticoagulation at an increased risk for major bleeding events, irrespective of the anticoagulant agent used.

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Section: Discussionsupporting

confidence: 89%

Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

Rief

Raggam

Hafner

et al. 2017

Semin Thromb Hemost

View full text Add to dashboard Cite

show abstract

The predictive ability of bleeding risk stratification models in very old patients on vitamin K antagonist treatment for venous thromboembolism: results of the prospective collaborative EPICA study: reply

Abstract: bleeding in elderly patients with venous thromboembolism. J Thromb Haemost 2013; 11: 435-43. 6 Beyth RJ, Quinn LM, Landefeld CS. Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med 1998; 105: 91-9.

Cited by 1 publication

References 9 publications

Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

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