A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity

V. Rosa-Salazar, J. Trujillo-Santos, J. A. Díaz Peromingo, A. Apollonio, O. Sanz, R. Malý, F. J. Muñoz-Rodriguez, J. C. Serrano, S. Soler, M. Monreal, H. Decousus, P. Prandoni, B. Brenner, R. Barba, P. Di Micco, L. Bertoletti, S. Schellong, I. Tzoran, A. Reis, M. BosevskiH. Bounameaux, P. Wells, M. Papadakis, M. D. Adarraga, A. Alibalic, A. Alvarado-Faria, J. I. Arcelus, T. Auguet, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, J. F. Benítez, A. Blanco-Molina, T. Bueso, A. Cañas, A. Casado, N. Castejón-Pina, E. L. Chaves, F. del Molino, J. del Toro, J. A. Díaz, C. Falgá, C. Fernández-Capitán, L. Font, P. Gallego, F. García-Bragado, A. García-Ortega, V. Gómez, J. González, D. González-Marcano, E. Grau, R. Guijarro, M. Guil, L. Guirado, J. Gutiérrez-Guisado, L. Hernández-Blasco, L. Jara-Palomares, M. J. Jaras, D. Jiménez, R. Jiménez, B. Lacruz, R. Lecumberri, J. L. Lobo, L. López-Jiménez, L. López-Montes, R. López-Reyes, J. B. López-Sáez, M. A. Lorente, A. Lorenzo, O. Madridano, A. Maestre, P. J. Marchena, J. M. Martín-Antorán, F. Martín-Martos, M. Montreal, M. V. Morales, D. Nauffal, J. A. Nieto, M. J. Núñez, S. Otalora, R. Otero, B. Pagán, J. M. Pedrajas, M. L. Peris, I. Pons, J. A. Porras, A. Riera-Mestre, A. Rivas, M. A. Rodríguez-Dávila, V. Rosa, N. Ruiz-Giménez, P. Sabio, A. Sampériz, R. Sánchez, M. J. Soto, J. M. Suriñach, G. Tiberio, R. Tirado, C. Tolosa, F. Uresandi, B. Valero, R. Valle, J. Vela, A. Villalobos, J. Villalta, P. Malfante, P. Verhamme, T. Vanassche, P. Wells, T. Tomko, J. Hirmerova, L. Bertoletti, A. Bura-Riviere, D. Farge-Bance, A. Hij, I. Mahe, A. Merah, F. Moustafa, I. Quere, S. Schellong, D. Babalis, M. Papadakis, I. Tzinieris, A. Braester, B. Brenner, I. Tzoran, G. Barillari, E. Bucherini, J. Campodomico, M. Ciammaichella, P. Di Micco, P. Ferrazzi, R. Maida, F. Pace, S. Pasca, R. Pesavento, C. Piovella, P. Prandoni, L. Rota, E. Tiraferri, A. Tufano, A. Visoná, A. Skride, A. Belovs, M. Moreira, J. L. Ribeiro, M. S. Sousa, M. Bosevski, A. Alatri, H. Bounameaux, L. Calanca, L. Mazzolai

Research output: Contribution to journalArticle

Abstract

Background: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy. Methods: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week. Results: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min-1, recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels <30 mL min-1. Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055. Conclusions: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.

Original languageEnglish
Pages (from-to)1274-1278
Number of pages5
JournalJournal of Thrombosis and Haemostasis
Volume13
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Upper Extremity Deep Vein Thrombosis
Outpatients
Confidence Intervals
Hemorrhage
Pulmonary Embolism
Creatinine
Platelet Count
Venous Thrombosis
Lower Extremity
Neoplasms
Heart Failure

Keywords

  • Anticoagulant therapy
  • Deep vein thrombosis
  • Hospital
  • Outcome
  • Outpatients
  • Upper extremity

ASJC Scopus subject areas

  • Hematology

Cite this

Rosa-Salazar, V., Trujillo-Santos, J., Díaz Peromingo, J. A., Apollonio, A., Sanz, O., Malý, R., ... Mazzolai, L. (2015). A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity. Journal of Thrombosis and Haemostasis, 13(7), 1274-1278. https://doi.org/10.1111/jth.13008

A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity. / Rosa-Salazar, V.; Trujillo-Santos, J.; Díaz Peromingo, J. A.; Apollonio, A.; Sanz, O.; Malý, R.; Muñoz-Rodriguez, F. J.; Serrano, J. C.; Soler, S.; Monreal, M.; Decousus, H.; Prandoni, P.; Brenner, B.; Barba, R.; Di Micco, P.; Bertoletti, L.; Schellong, S.; Tzoran, I.; Reis, A.; Bosevski, M.; Bounameaux, H.; Wells, P.; Papadakis, M.; Adarraga, M. D.; Alibalic, A.; Alvarado-Faria, A.; Arcelus, J. I.; Auguet, T.; Ballaz, A.; Barba, R.; Barrón, M.; Barrón-Andrés, B.; Bascuñana, J.; Benítez, J. F.; Blanco-Molina, A.; Bueso, T.; Cañas, A.; Casado, A.; Castejón-Pina, N.; Chaves, E. L.; del Molino, F.; del Toro, J.; Díaz, J. A.; Falgá, C.; Fernández-Capitán, C.; Font, L.; Gallego, P.; García-Bragado, F.; García-Ortega, A.; Gómez, V.; González, J.; González-Marcano, D.; Grau, E.; Guijarro, R.; Guil, M.; Guirado, L.; Gutiérrez-Guisado, J.; Hernández-Blasco, L.; Jara-Palomares, L.; Jaras, M. J.; Jiménez, D.; Jiménez, R.; Lacruz, B.; Lecumberri, R.; Lobo, J. L.; López-Jiménez, L.; López-Montes, L.; López-Reyes, R.; López-Sáez, J. B.; Lorente, M. A.; Lorenzo, A.; Madridano, O.; Maestre, A.; Marchena, P. J.; Martín-Antorán, J. M.; Martín-Martos, F.; Montreal, M.; Morales, M. V.; Nauffal, D.; Nieto, J. A.; Núñez, M. J.; Otalora, S.; Otero, R.; Pagán, B.; Pedrajas, J. M.; Peris, M. L.; Pons, I.; Porras, J. A.; Riera-Mestre, A.; Rivas, A.; Rodríguez-Dávila, M. A.; Rosa, V.; Ruiz-Giménez, N.; Sabio, P.; Sampériz, A.; Sánchez, R.; Soto, M. J.; Suriñach, J. M.; Tiberio, G.; Tirado, R.; Tolosa, C.; Uresandi, F.; Valero, B.; Valle, R.; Vela, J.; Villalobos, A.; Villalta, J.; Malfante, P.; Verhamme, P.; Vanassche, T.; Wells, P.; Tomko, T.; Hirmerova, J.; Bertoletti, L.; Bura-Riviere, A.; Farge-Bance, D.; Hij, A.; Mahe, I.; Merah, A.; Moustafa, F.; Quere, I.; Schellong, S.; Babalis, D.; Papadakis, M.; Tzinieris, I.; Braester, A.; Brenner, B.; Tzoran, I.; Barillari, G.; Bucherini, E.; Campodomico, J.; Ciammaichella, M.; Di Micco, P.; Ferrazzi, P.; Maida, R.; Pace, F.; Pasca, S.; Pesavento, R.; Piovella, C.; Prandoni, P.; Rota, L.; Tiraferri, E.; Tufano, A.; Visoná, A.; Skride, A.; Belovs, A.; Moreira, M.; Ribeiro, J. L.; Sousa, M. S.; Bosevski, M.; Alatri, A.; Bounameaux, H.; Calanca, L.; Mazzolai, L.

In: Journal of Thrombosis and Haemostasis, Vol. 13, No. 7, 01.07.2015, p. 1274-1278.

Research output: Contribution to journalArticle

Rosa-Salazar, V, Trujillo-Santos, J, Díaz Peromingo, JA, Apollonio, A, Sanz, O, Malý, R, Muñoz-Rodriguez, FJ, Serrano, JC, Soler, S, Monreal, M, Decousus, H, Prandoni, P, Brenner, B, Barba, R, Di Micco, P, Bertoletti, L, Schellong, S, Tzoran, I, Reis, A, Bosevski, M, Bounameaux, H, Wells, P, Papadakis, M, Adarraga, MD, Alibalic, A, Alvarado-Faria, A, Arcelus, JI, Auguet, T, Ballaz, A, Barba, R, Barrón, M, Barrón-Andrés, B, Bascuñana, J, Benítez, JF, Blanco-Molina, A, Bueso, T, Cañas, A, Casado, A, Castejón-Pina, N, Chaves, EL, del Molino, F, del Toro, J, Díaz, JA, Falgá, C, Fernández-Capitán, C, Font, L, Gallego, P, García-Bragado, F, García-Ortega, A, Gómez, V, González, J, González-Marcano, D, Grau, E, Guijarro, R, Guil, M, Guirado, L, Gutiérrez-Guisado, J, Hernández-Blasco, L, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Jiménez, R, Lacruz, B, Lecumberri, R, Lobo, JL, López-Jiménez, L, López-Montes, L, López-Reyes, R, López-Sáez, JB, Lorente, MA, Lorenzo, A, Madridano, O, Maestre, A, Marchena, PJ, Martín-Antorán, JM, Martín-Martos, F, Montreal, M, Morales, MV, Nauffal, D, Nieto, JA, Núñez, MJ, Otalora, S, Otero, R, Pagán, B, Pedrajas, JM, Peris, ML, Pons, I, Porras, JA, Riera-Mestre, A, Rivas, A, Rodríguez-Dávila, MA, Rosa, V, Ruiz-Giménez, N, Sabio, P, Sampériz, A, Sánchez, R, Soto, MJ, Suriñach, JM, Tiberio, G, Tirado, R, Tolosa, C, Uresandi, F, Valero, B, Valle, R, Vela, J, Villalobos, A, Villalta, J, Malfante, P, Verhamme, P, Vanassche, T, Wells, P, Tomko, T, Hirmerova, J, Bertoletti, L, Bura-Riviere, A, Farge-Bance, D, Hij, A, Mahe, I, Merah, A, Moustafa, F, Quere, I, Schellong, S, Babalis, D, Papadakis, M, Tzinieris, I, Braester, A, Brenner, B, Tzoran, I, Barillari, G, Bucherini, E, Campodomico, J, Ciammaichella, M, Di Micco, P, Ferrazzi, P, Maida, R, Pace, F, Pasca, S, Pesavento, R, Piovella, C, Prandoni, P, Rota, L, Tiraferri, E, Tufano, A, Visoná, A, Skride, A, Belovs, A, Moreira, M, Ribeiro, JL, Sousa, MS, Bosevski, M, Alatri, A, Bounameaux, H, Calanca, L & Mazzolai, L 2015, 'A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity', Journal of Thrombosis and Haemostasis, vol. 13, no. 7, pp. 1274-1278. https://doi.org/10.1111/jth.13008
Rosa-Salazar V, Trujillo-Santos J, Díaz Peromingo JA, Apollonio A, Sanz O, Malý R et al. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity. Journal of Thrombosis and Haemostasis. 2015 Jul 1;13(7):1274-1278. https://doi.org/10.1111/jth.13008
Rosa-Salazar, V. ; Trujillo-Santos, J. ; Díaz Peromingo, J. A. ; Apollonio, A. ; Sanz, O. ; Malý, R. ; Muñoz-Rodriguez, F. J. ; Serrano, J. C. ; Soler, S. ; Monreal, M. ; Decousus, H. ; Prandoni, P. ; Brenner, B. ; Barba, R. ; Di Micco, P. ; Bertoletti, L. ; Schellong, S. ; Tzoran, I. ; Reis, A. ; Bosevski, M. ; Bounameaux, H. ; Wells, P. ; Papadakis, M. ; Adarraga, M. D. ; Alibalic, A. ; Alvarado-Faria, A. ; Arcelus, J. I. ; Auguet, T. ; Ballaz, A. ; Barba, R. ; Barrón, M. ; Barrón-Andrés, B. ; Bascuñana, J. ; Benítez, J. F. ; Blanco-Molina, A. ; Bueso, T. ; Cañas, A. ; Casado, A. ; Castejón-Pina, N. ; Chaves, E. L. ; del Molino, F. ; del Toro, J. ; Díaz, J. A. ; Falgá, C. ; Fernández-Capitán, C. ; Font, L. ; Gallego, P. ; García-Bragado, F. ; García-Ortega, A. ; Gómez, V. ; González, J. ; González-Marcano, D. ; Grau, E. ; Guijarro, R. ; Guil, M. ; Guirado, L. ; Gutiérrez-Guisado, J. ; Hernández-Blasco, L. ; Jara-Palomares, L. ; Jaras, M. J. ; Jiménez, D. ; Jiménez, R. ; Lacruz, B. ; Lecumberri, R. ; Lobo, J. L. ; López-Jiménez, L. ; López-Montes, L. ; López-Reyes, R. ; López-Sáez, J. B. ; Lorente, M. A. ; Lorenzo, A. ; Madridano, O. ; Maestre, A. ; Marchena, P. J. ; Martín-Antorán, J. M. ; Martín-Martos, F. ; Montreal, M. ; Morales, M. V. ; Nauffal, D. ; Nieto, J. A. ; Núñez, M. J. ; Otalora, S. ; Otero, R. ; Pagán, B. ; Pedrajas, J. M. ; Peris, M. L. ; Pons, I. ; Porras, J. A. ; Riera-Mestre, A. ; Rivas, A. ; Rodríguez-Dávila, M. A. ; Rosa, V. ; Ruiz-Giménez, N. ; Sabio, P. ; Sampériz, A. ; Sánchez, R. ; Soto, M. J. ; Suriñach, J. M. ; Tiberio, G. ; Tirado, R. ; Tolosa, C. ; Uresandi, F. ; Valero, B. ; Valle, R. ; Vela, J. ; Villalobos, A. ; Villalta, J. ; Malfante, P. ; Verhamme, P. ; Vanassche, T. ; Wells, P. ; Tomko, T. ; Hirmerova, J. ; Bertoletti, L. ; Bura-Riviere, A. ; Farge-Bance, D. ; Hij, A. ; Mahe, I. ; Merah, A. ; Moustafa, F. ; Quere, I. ; Schellong, S. ; Babalis, D. ; Papadakis, M. ; Tzinieris, I. ; Braester, A. ; Brenner, B. ; Tzoran, I. ; Barillari, G. ; Bucherini, E. ; Campodomico, J. ; Ciammaichella, M. ; Di Micco, P. ; Ferrazzi, P. ; Maida, R. ; Pace, F. ; Pasca, S. ; Pesavento, R. ; Piovella, C. ; Prandoni, P. ; Rota, L. ; Tiraferri, E. ; Tufano, A. ; Visoná, A. ; Skride, A. ; Belovs, A. ; Moreira, M. ; Ribeiro, J. L. ; Sousa, M. S. ; Bosevski, M. ; Alatri, A. ; Bounameaux, H. ; Calanca, L. ; Mazzolai, L. / A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity. In: Journal of Thrombosis and Haemostasis. 2015 ; Vol. 13, No. 7. pp. 1274-1278.
@article{b2c814f70f0c441d916d4d9f9b0ab14d,
title = "A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity",
abstract = "Background: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy. Methods: We used data from Registro Informatizado de la Enfermedad TromboEmb{\'o}lica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week. Results: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45{\%}) were treated at home. During the first week, three patients (0.26{\%}) experienced pulmonary embolism, two (0.18{\%}) had major bleeding, and four (0.35{\%}) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min-1, recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels <30 mL min-1. Overall, 759 (67{\%}) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26{\%} (95{\%} confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86{\%} (95{\%} CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95{\%} CI 0.57-0.88). Net reclassification improvement was 22{\%}, and integrated discrimination improvement was 0.0055. Conclusions: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.",
keywords = "Anticoagulant therapy, Deep vein thrombosis, Hospital, Outcome, Outpatients, Upper extremity",
author = "V. Rosa-Salazar and J. Trujillo-Santos and {D{\'i}az Peromingo}, {J. A.} and A. Apollonio and O. Sanz and R. Mal{\'y} and Mu{\~n}oz-Rodriguez, {F. J.} and Serrano, {J. C.} and S. Soler and M. Monreal and H. Decousus and P. Prandoni and B. Brenner and R. Barba and {Di Micco}, P. and L. Bertoletti and S. Schellong and I. Tzoran and A. Reis and M. Bosevski and H. Bounameaux and P. Wells and M. Papadakis and Adarraga, {M. D.} and A. Alibalic and A. Alvarado-Faria and Arcelus, {J. I.} and T. Auguet and A. Ballaz and R. Barba and M. Barr{\'o}n and B. Barr{\'o}n-Andr{\'e}s and J. Bascu{\~n}ana and Ben{\'i}tez, {J. F.} and A. Blanco-Molina and T. Bueso and A. Ca{\~n}as and A. Casado and N. Castej{\'o}n-Pina and Chaves, {E. L.} and {del Molino}, F. and {del Toro}, J. and D{\'i}az, {J. A.} and C. Falg{\'a} and C. Fern{\'a}ndez-Capit{\'a}n and L. Font and P. Gallego and F. Garc{\'i}a-Bragado and A. Garc{\'i}a-Ortega and V. G{\'o}mez and J. Gonz{\'a}lez and D. Gonz{\'a}lez-Marcano and E. Grau and R. Guijarro and M. Guil and L. Guirado and J. Guti{\'e}rrez-Guisado and L. Hern{\'a}ndez-Blasco and L. Jara-Palomares and Jaras, {M. J.} and D. Jim{\'e}nez and R. Jim{\'e}nez and B. Lacruz and R. Lecumberri and Lobo, {J. L.} and L. L{\'o}pez-Jim{\'e}nez and L. L{\'o}pez-Montes and R. L{\'o}pez-Reyes and L{\'o}pez-S{\'a}ez, {J. B.} and Lorente, {M. A.} and A. Lorenzo and O. Madridano and A. Maestre and Marchena, {P. J.} and Mart{\'i}n-Antor{\'a}n, {J. M.} and F. Mart{\'i}n-Martos and M. Montreal and Morales, {M. V.} and D. Nauffal and Nieto, {J. A.} and N{\'u}{\~n}ez, {M. J.} and S. Otalora and R. Otero and B. Pag{\'a}n and Pedrajas, {J. M.} and Peris, {M. L.} and I. Pons and Porras, {J. A.} and A. Riera-Mestre and A. Rivas and Rodr{\'i}guez-D{\'a}vila, {M. A.} and V. Rosa and N. Ruiz-Gim{\'e}nez and P. Sabio and A. Samp{\'e}riz and R. S{\'a}nchez and Soto, {M. J.} and Suri{\~n}ach, {J. M.} and G. Tiberio and R. Tirado and C. Tolosa and F. Uresandi and B. Valero and R. Valle and J. Vela and A. Villalobos and J. Villalta and P. Malfante and P. Verhamme and T. Vanassche and P. Wells and T. Tomko and J. Hirmerova and L. Bertoletti and A. Bura-Riviere and D. Farge-Bance and A. Hij and I. Mahe and A. Merah and F. Moustafa and I. Quere and S. Schellong and D. Babalis and M. Papadakis and I. Tzinieris and A. Braester and B. Brenner and I. Tzoran and G. Barillari and E. Bucherini and J. Campodomico and M. Ciammaichella and {Di Micco}, P. and P. Ferrazzi and R. Maida and F. Pace and S. Pasca and R. Pesavento and C. Piovella and P. Prandoni and L. Rota and E. Tiraferri and A. Tufano and A. Vison{\'a} and A. Skride and A. Belovs and M. Moreira and Ribeiro, {J. L.} and Sousa, {M. S.} and M. Bosevski and A. Alatri and H. Bounameaux and L. Calanca and L. Mazzolai",
year = "2015",
month = "7",
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doi = "10.1111/jth.13008",
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pages = "1274--1278",
journal = "Journal of Thrombosis and Haemostasis",
issn = "1538-7933",
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TY - JOUR

T1 - A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the upper extremity

AU - Rosa-Salazar, V.

AU - Trujillo-Santos, J.

AU - Díaz Peromingo, J. A.

AU - Apollonio, A.

AU - Sanz, O.

AU - Malý, R.

AU - Muñoz-Rodriguez, F. J.

AU - Serrano, J. C.

AU - Soler, S.

AU - Monreal, M.

AU - Decousus, H.

AU - Prandoni, P.

AU - Brenner, B.

AU - Barba, R.

AU - Di Micco, P.

AU - Bertoletti, L.

AU - Schellong, S.

AU - Tzoran, I.

AU - Reis, A.

AU - Bosevski, M.

AU - Bounameaux, H.

AU - Wells, P.

AU - Papadakis, M.

AU - Adarraga, M. D.

AU - Alibalic, A.

AU - Alvarado-Faria, A.

AU - Arcelus, J. I.

AU - Auguet, T.

AU - Ballaz, A.

AU - Barba, R.

AU - Barrón, M.

AU - Barrón-Andrés, B.

AU - Bascuñana, J.

AU - Benítez, J. F.

AU - Blanco-Molina, A.

AU - Bueso, T.

AU - Cañas, A.

AU - Casado, A.

AU - Castejón-Pina, N.

AU - Chaves, E. L.

AU - del Molino, F.

AU - del Toro, J.

AU - Díaz, J. A.

AU - Falgá, C.

AU - Fernández-Capitán, C.

AU - Font, L.

AU - Gallego, P.

AU - García-Bragado, F.

AU - García-Ortega, A.

AU - Gómez, V.

AU - González, J.

AU - González-Marcano, D.

AU - Grau, E.

AU - Guijarro, R.

AU - Guil, M.

AU - Guirado, L.

AU - Gutiérrez-Guisado, J.

AU - Hernández-Blasco, L.

AU - Jara-Palomares, L.

AU - Jaras, M. J.

AU - Jiménez, D.

AU - Jiménez, R.

AU - Lacruz, B.

AU - Lecumberri, R.

AU - Lobo, J. L.

AU - López-Jiménez, L.

AU - López-Montes, L.

AU - López-Reyes, R.

AU - López-Sáez, J. B.

AU - Lorente, M. A.

AU - Lorenzo, A.

AU - Madridano, O.

AU - Maestre, A.

AU - Marchena, P. J.

AU - Martín-Antorán, J. M.

AU - Martín-Martos, F.

AU - Montreal, M.

AU - Morales, M. V.

AU - Nauffal, D.

AU - Nieto, J. A.

AU - Núñez, M. J.

AU - Otalora, S.

AU - Otero, R.

AU - Pagán, B.

AU - Pedrajas, J. M.

AU - Peris, M. L.

AU - Pons, I.

AU - Porras, J. A.

AU - Riera-Mestre, A.

AU - Rivas, A.

AU - Rodríguez-Dávila, M. A.

AU - Rosa, V.

AU - Ruiz-Giménez, N.

AU - Sabio, P.

AU - Sampériz, A.

AU - Sánchez, R.

AU - Soto, M. J.

AU - Suriñach, J. M.

AU - Tiberio, G.

AU - Tirado, R.

AU - Tolosa, C.

AU - Uresandi, F.

AU - Valero, B.

AU - Valle, R.

AU - Vela, J.

AU - Villalobos, A.

AU - Villalta, J.

AU - Malfante, P.

AU - Verhamme, P.

AU - Vanassche, T.

AU - Wells, P.

AU - Tomko, T.

AU - Hirmerova, J.

AU - Bertoletti, L.

AU - Bura-Riviere, A.

AU - Farge-Bance, D.

AU - Hij, A.

AU - Mahe, I.

AU - Merah, A.

AU - Moustafa, F.

AU - Quere, I.

AU - Schellong, S.

AU - Babalis, D.

AU - Papadakis, M.

AU - Tzinieris, I.

AU - Braester, A.

AU - Brenner, B.

AU - Tzoran, I.

AU - Barillari, G.

AU - Bucherini, E.

AU - Campodomico, J.

AU - Ciammaichella, M.

AU - Di Micco, P.

AU - Ferrazzi, P.

AU - Maida, R.

AU - Pace, F.

AU - Pasca, S.

AU - Pesavento, R.

AU - Piovella, C.

AU - Prandoni, P.

AU - Rota, L.

AU - Tiraferri, E.

AU - Tufano, A.

AU - Visoná, A.

AU - Skride, A.

AU - Belovs, A.

AU - Moreira, M.

AU - Ribeiro, J. L.

AU - Sousa, M. S.

AU - Bosevski, M.

AU - Alatri, A.

AU - Bounameaux, H.

AU - Calanca, L.

AU - Mazzolai, L.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy. Methods: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week. Results: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min-1, recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels <30 mL min-1. Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055. Conclusions: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.

AB - Background: No studies have identified which patients with upper-extremity deep vein thrombosis (DVT) are at low risk for adverse events within the first week of therapy. Methods: We used data from Registro Informatizado de la Enfermedad TromboEmbólica to explore in patients with upper-extremity DVT a prognostic score that correctly identified patients with lower limb DVT at low risk for pulmonary embolism, major bleeding, or death within the first week. Results: As of December 2014, 1135 outpatients with upper-extremity DVT were recruited. Of these, 515 (45%) were treated at home. During the first week, three patients (0.26%) experienced pulmonary embolism, two (0.18%) had major bleeding, and four (0.35%) died. We assigned 1 point to patients with chronic heart failure, creatinine clearance levels 30-60 mL min-1, recent bleeding, abnormal platelet count, recent immobility, or cancer without metastases; 2 points to those with metastatic cancer; and 3 points to those with creatinine clearance levels <30 mL min-1. Overall, 759 (67%) patients scored ≤ 1 point and were considered to be at low risk. The rate of the composite outcome within the first week was 0.26% (95% confidence interval [CI] 0.004-0.87) in patients at low risk and 1.86% (95% CI 0.81-3.68) in the remaining patients. C-statistics was 0.73 (95% CI 0.57-0.88). Net reclassification improvement was 22%, and integrated discrimination improvement was 0.0055. Conclusions: Using six easily available variables, we identified outpatients with upper-extremity DVT at low risk for adverse events within the first week. These data may help to safely treat more patients at home.

KW - Anticoagulant therapy

KW - Deep vein thrombosis

KW - Hospital

KW - Outcome

KW - Outpatients

KW - Upper extremity

UR - http://www.scopus.com/inward/record.url?scp=84935739964&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84935739964&partnerID=8YFLogxK

U2 - 10.1111/jth.13008

DO - 10.1111/jth.13008

M3 - Article

C2 - 25980766

AN - SCOPUS:84935739964

VL - 13

SP - 1274

EP - 1278

JO - Journal of Thrombosis and Haemostasis

JF - Journal of Thrombosis and Haemostasis

SN - 1538-7933

IS - 7

ER -