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

Summary 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‐extremi...

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Veröffentlicht in:	Journal of thrombosis and haemostasis 2015-07, Vol.13 (7), p.1274-1278
Hauptverfasser:	Trujillo‐Santos, J., Apollonio, A., Sanz, O., Malý, R., Muñoz‐Rodriguez, F. J., Serrano, J. C., Monreal, M., Decousus, H., Prandoni, P., Brenner, B., Schellong, S., Tzoran, I., Reis, A., Wells, P., Papadakis, M., Alibalic, A., Alvarado‐Faria, A., Auguet, T., Ballaz, A., Barrón‐Andrés, B., Bascuñana, J., Benítez, J. F., Blanco‐Molina, A., Bueso, T., Cañas, A., Casado, A., Chaves, E. L., Toro, J, Font, L., Gallego, P., García‐Ortega, A., Gómez, V., González, J., Guijarro, R., Guil, M., Guirado, L., Hernández‐Blasco, L., Jiménez, R., Lacruz, B., López‐Jiménez, L., López‐Montes, L., López‐Reyes, R., López‐Sáez, J. B., Lorente, M. A., Marchena, P. J., Martín‐Antorán, J. M., Martín‐Martos, F., Morales, M. V., Nauffal, D., Nieto, J. A., 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., Ruiz‐Giménez, N., Sabio, P., Soto, M. J., Tiberio, G., Tolosa, C., Valero, B., Valle, R., Vela, J., Villalobos, A., Villalta, J., Malfante, P., Verhamme, P., Vanassche, T., Hirmerova, J., Bura‐Riviere, A., Farge‐Bancel, D., Hij, A., Mahe, I., Moustafa, F., Quere, I., Babalis, D., Tzinieris, I., Braester, A., Barillari, G., Bucherini, E., Ciammaichella, M., Pace, F., Pesavento, R., Piovella, C., Rota, L., Tiraferri, E., Tufano, A., Visonà, A., Skride, A., Belovs, A., Moreira, M., Ribeiro, J. L., Sousa, M. S., Alatri, A., Calanca, L.
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Aged anticoagulant therapy Anticoagulants - adverse effects Canada Confidence intervals Decision Support Techniques deep vein thrombosis Embolisms Europe Female Health risk assessment Hematology Hemorrhage - chemically induced hospital Human health and pathology Humans Israel Life Sciences Male Middle Aged outcome Outpatients Predictive Value of Tests Pulmonary Embolism - diagnosis Pulmonary Embolism - etiology Pulmonary Embolism - mortality Pulmonary Embolism - prevention & control Registries Risk Assessment Risk Factors South America Thrombosis Time Factors Treatment Outcome upper extremity Upper Extremity Deep Vein Thrombosis - diagnosis Upper Extremity Deep Vein Thrombosis - etiology Upper Extremity Deep Vein Thrombosis - mortality Upper Extremity Deep Vein Thrombosis - therapy
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container_issue	7
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container_title	Journal of thrombosis and haemostasis
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creator	Trujillo‐Santos, J. Apollonio, A. Sanz, O. Malý, R. Muñoz‐Rodriguez, F. J. Serrano, J. C. Monreal, M. Decousus, H. Prandoni, P. Brenner, B. Schellong, S. Tzoran, I. Reis, A. Wells, P. Papadakis, M. Alibalic, A. Alvarado‐Faria, A. Auguet, T. Ballaz, A. Barrón‐Andrés, B. Bascuñana, J. Benítez, J. F. Blanco‐Molina, A. Bueso, T. Cañas, A. Casado, A. Chaves, E. L. Toro, J Font, L. Gallego, P. García‐Ortega, A. Gómez, V. González, J. Guijarro, R. Guil, M. Guirado, L. Hernández‐Blasco, L. Jiménez, R. Lacruz, B. López‐Jiménez, L. López‐Montes, L. López‐Reyes, R. López‐Sáez, J. B. Lorente, M. A. Marchena, P. J. Martín‐Antorán, J. M. Martín‐Martos, F. Morales, M. V. Nauffal, D. Nieto, J. A. 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. Ruiz‐Giménez, N. Sabio, P. Soto, M. J. Tiberio, G. Tolosa, C. Valero, B. Valle, R. Vela, J. Villalobos, A. Villalta, J. Malfante, P. Verhamme, P. Vanassche, T. Hirmerova, J. Bura‐Riviere, A. Farge‐Bancel, D. Hij, A. Mahe, I. Moustafa, F. Quere, I. Babalis, D. Tzinieris, I. Braester, A. Barillari, G. Bucherini, E. Ciammaichella, M. Pace, F. Pesavento, R. Piovella, C. Rota, L. Tiraferri, E. Tufano, A. Visonà, A. Skride, A. Belovs, A. Moreira, M. Ribeiro, J. L. Sousa, M. S. Alatri, A. Calanca, L.
description	Summary 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
doi_str_mv	10.1111/jth.13008
format	Article
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J. ; Serrano, J. C. ; Monreal, M. ; Decousus, H. ; Prandoni, P. ; Brenner, B. ; Schellong, S. ; Tzoran, I. ; Reis, A. ; Wells, P. ; Papadakis, M. ; Alibalic, A. ; Alvarado‐Faria, A. ; Auguet, T. ; Ballaz, A. ; Barrón‐Andrés, B. ; Bascuñana, J. ; Benítez, J. F. ; Blanco‐Molina, A. ; Bueso, T. ; Cañas, A. ; Casado, A. ; Chaves, E. L. ; Toro, J ; Font, L. ; Gallego, P. ; García‐Ortega, A. ; Gómez, V. ; González, J. ; Guijarro, R. ; Guil, M. ; Guirado, L. ; Hernández‐Blasco, L. ; Jiménez, R. ; Lacruz, B. ; López‐Jiménez, L. ; López‐Montes, L. ; López‐Reyes, R. ; López‐Sáez, J. B. ; Lorente, M. A. ; Marchena, P. J. ; Martín‐Antorán, J. M. ; Martín‐Martos, F. ; Morales, M. V. ; Nauffal, D. ; Nieto, J. A. ; 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. ; Ruiz‐Giménez, N. ; Sabio, P. ; Soto, M. J. ; Tiberio, G. ; Tolosa, C. ; Valero, B. ; Valle, R. ; Vela, J. ; Villalobos, A. ; Villalta, J. ; Malfante, P. ; Verhamme, P. ; Vanassche, T. ; Hirmerova, J. ; Bura‐Riviere, A. ; Farge‐Bancel, D. ; Hij, A. ; Mahe, I. ; Moustafa, F. ; Quere, I. ; Babalis, D. ; Tzinieris, I. ; Braester, A. ; Barillari, G. ; Bucherini, E. ; Ciammaichella, M. ; Pace, F. ; Pesavento, R. ; Piovella, C. ; Rota, L. ; Tiraferri, E. ; Tufano, A. ; Visonà, A. ; Skride, A. ; Belovs, A. ; Moreira, M. ; Ribeiro, J. L. ; Sousa, M. S. ; Alatri, A. ; Calanca, L.</creator><creatorcontrib>Trujillo‐Santos, J. ; Apollonio, A. ; Sanz, O. ; Malý, R. ; Muñoz‐Rodriguez, F. J. ; Serrano, J. C. ; Monreal, M. ; Decousus, H. ; Prandoni, P. ; Brenner, B. ; Schellong, S. ; Tzoran, I. ; Reis, A. ; Wells, P. ; Papadakis, M. ; Alibalic, A. ; Alvarado‐Faria, A. ; Auguet, T. ; Ballaz, A. ; Barrón‐Andrés, B. ; Bascuñana, J. ; Benítez, J. F. ; Blanco‐Molina, A. ; Bueso, T. ; Cañas, A. ; Casado, A. ; Chaves, E. L. ; Toro, J ; Font, L. ; Gallego, P. ; García‐Ortega, A. ; Gómez, V. ; González, J. ; Guijarro, R. ; Guil, M. ; Guirado, L. ; Hernández‐Blasco, L. ; Jiménez, R. ; Lacruz, B. ; López‐Jiménez, L. ; López‐Montes, L. ; López‐Reyes, R. ; López‐Sáez, J. B. ; Lorente, M. A. ; Marchena, P. J. ; Martín‐Antorán, J. M. ; Martín‐Martos, F. ; Morales, M. V. ; Nauffal, D. ; Nieto, J. A. ; 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. ; Ruiz‐Giménez, N. ; Sabio, P. ; Soto, M. J. ; Tiberio, G. ; Tolosa, C. ; Valero, B. ; Valle, R. ; Vela, J. ; Villalobos, A. ; Villalta, J. ; Malfante, P. ; Verhamme, P. ; Vanassche, T. ; Hirmerova, J. ; Bura‐Riviere, A. ; Farge‐Bancel, D. ; Hij, A. ; Mahe, I. ; Moustafa, F. ; Quere, I. ; Babalis, D. ; Tzinieris, I. ; Braester, A. ; Barillari, G. ; Bucherini, E. ; Ciammaichella, M. ; Pace, F. ; Pesavento, R. ; Piovella, C. ; Rota, L. ; Tiraferri, E. ; Tufano, A. ; Visonà, A. ; Skride, A. ; Belovs, A. ; Moreira, M. ; Ribeiro, J. L. ; Sousa, M. S. ; Alatri, A. ; Calanca, L. ; RIETE Investigators</creatorcontrib><description>Summary 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.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1111/jth.13008</identifier><identifier>PMID: 25980766</identifier><language>eng</language><publisher>England: Elsevier Limited</publisher><subject>Adult ; Aged ; anticoagulant therapy ; Anticoagulants - adverse effects ; Canada ; Confidence intervals ; Decision Support Techniques ; deep vein thrombosis ; Embolisms ; Europe ; Female ; Health risk assessment ; Hematology ; Hemorrhage - chemically induced ; hospital ; Human health and pathology ; Humans ; Israel ; Life Sciences ; Male ; Middle Aged ; outcome ; Outpatients ; Predictive Value of Tests ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - etiology ; Pulmonary Embolism - mortality ; Pulmonary Embolism - prevention & control ; Registries ; Risk Assessment ; Risk Factors ; South America ; Thrombosis ; Time Factors ; Treatment Outcome ; upper extremity ; Upper Extremity Deep Vein Thrombosis - diagnosis ; Upper Extremity Deep Vein Thrombosis - etiology ; Upper Extremity Deep Vein Thrombosis - mortality ; Upper Extremity Deep Vein Thrombosis - therapy</subject><ispartof>Journal of thrombosis and haemostasis, 2015-07, Vol.13 (7), p.1274-1278</ispartof><rights>2015 International Society on Thrombosis and Haemostasis</rights><rights>2015 International Society on Thrombosis and Haemostasis.</rights><rights>Copyright © 2015 International Society on Thrombosis and Haemostasis</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4928-b0e9b95fde654c2a30ebfc5eb67e468c77a7b95ecb4a305d180129741bd3c7633</citedby><cites>FETCH-LOGICAL-c4928-b0e9b95fde654c2a30ebfc5eb67e468c77a7b95ecb4a305d180129741bd3c7633</cites><orcidid>0000-0002-1492-9764</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25980766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.umontpellier.fr/hal-01944477$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Trujillo‐Santos, J.</creatorcontrib><creatorcontrib>Apollonio, A.</creatorcontrib><creatorcontrib>Sanz, O.</creatorcontrib><creatorcontrib>Malý, R.</creatorcontrib><creatorcontrib>Muñoz‐Rodriguez, F. J.</creatorcontrib><creatorcontrib>Serrano, J. C.</creatorcontrib><creatorcontrib>Monreal, M.</creatorcontrib><creatorcontrib>Decousus, H.</creatorcontrib><creatorcontrib>Prandoni, P.</creatorcontrib><creatorcontrib>Brenner, B.</creatorcontrib><creatorcontrib>Schellong, S.</creatorcontrib><creatorcontrib>Tzoran, I.</creatorcontrib><creatorcontrib>Reis, A.</creatorcontrib><creatorcontrib>Wells, P.</creatorcontrib><creatorcontrib>Papadakis, M.</creatorcontrib><creatorcontrib>Alibalic, A.</creatorcontrib><creatorcontrib>Alvarado‐Faria, A.</creatorcontrib><creatorcontrib>Auguet, T.</creatorcontrib><creatorcontrib>Ballaz, A.</creatorcontrib><creatorcontrib>Barrón‐Andrés, B.</creatorcontrib><creatorcontrib>Bascuñana, J.</creatorcontrib><creatorcontrib>Benítez, J. F.</creatorcontrib><creatorcontrib>Blanco‐Molina, A.</creatorcontrib><creatorcontrib>Bueso, T.</creatorcontrib><creatorcontrib>Cañas, A.</creatorcontrib><creatorcontrib>Casado, A.</creatorcontrib><creatorcontrib>Chaves, E. L.</creatorcontrib><creatorcontrib>Toro, J</creatorcontrib><creatorcontrib>Font, L.</creatorcontrib><creatorcontrib>Gallego, P.</creatorcontrib><creatorcontrib>García‐Ortega, A.</creatorcontrib><creatorcontrib>Gómez, V.</creatorcontrib><creatorcontrib>González, J.</creatorcontrib><creatorcontrib>Guijarro, R.</creatorcontrib><creatorcontrib>Guil, M.</creatorcontrib><creatorcontrib>Guirado, L.</creatorcontrib><creatorcontrib>Hernández‐Blasco, L.</creatorcontrib><creatorcontrib>Jiménez, R.</creatorcontrib><creatorcontrib>Lacruz, B.</creatorcontrib><creatorcontrib>López‐Jiménez, L.</creatorcontrib><creatorcontrib>López‐Montes, L.</creatorcontrib><creatorcontrib>López‐Reyes, R.</creatorcontrib><creatorcontrib>López‐Sáez, J. B.</creatorcontrib><creatorcontrib>Lorente, M. A.</creatorcontrib><creatorcontrib>Marchena, P. J.</creatorcontrib><creatorcontrib>Martín‐Antorán, J. M.</creatorcontrib><creatorcontrib>Martín‐Martos, F.</creatorcontrib><creatorcontrib>Morales, M. V.</creatorcontrib><creatorcontrib>Nauffal, D.</creatorcontrib><creatorcontrib>Nieto, J. A.</creatorcontrib><creatorcontrib>Otalora, S.</creatorcontrib><creatorcontrib>Otero, R.</creatorcontrib><creatorcontrib>Pagán, B.</creatorcontrib><creatorcontrib>Pedrajas, J. M.</creatorcontrib><creatorcontrib>Peris, M. L.</creatorcontrib><creatorcontrib>Pons, I.</creatorcontrib><creatorcontrib>Porras, J. A.</creatorcontrib><creatorcontrib>Riera‐Mestre, A.</creatorcontrib><creatorcontrib>Rivas, A.</creatorcontrib><creatorcontrib>Rodríguez‐Dávila, M. A.</creatorcontrib><creatorcontrib>Ruiz‐Giménez, N.</creatorcontrib><creatorcontrib>Sabio, P.</creatorcontrib><creatorcontrib>Soto, M. J.</creatorcontrib><creatorcontrib>Tiberio, G.</creatorcontrib><creatorcontrib>Tolosa, C.</creatorcontrib><creatorcontrib>Valero, B.</creatorcontrib><creatorcontrib>Valle, R.</creatorcontrib><creatorcontrib>Vela, J.</creatorcontrib><creatorcontrib>Villalobos, A.</creatorcontrib><creatorcontrib>Villalta, J.</creatorcontrib><creatorcontrib>Malfante, P.</creatorcontrib><creatorcontrib>Verhamme, P.</creatorcontrib><creatorcontrib>Vanassche, T.</creatorcontrib><creatorcontrib>Hirmerova, J.</creatorcontrib><creatorcontrib>Bura‐Riviere, A.</creatorcontrib><creatorcontrib>Farge‐Bancel, D.</creatorcontrib><creatorcontrib>Hij, A.</creatorcontrib><creatorcontrib>Mahe, I.</creatorcontrib><creatorcontrib>Moustafa, F.</creatorcontrib><creatorcontrib>Quere, I.</creatorcontrib><creatorcontrib>Babalis, D.</creatorcontrib><creatorcontrib>Tzinieris, I.</creatorcontrib><creatorcontrib>Braester, A.</creatorcontrib><creatorcontrib>Barillari, G.</creatorcontrib><creatorcontrib>Bucherini, E.</creatorcontrib><creatorcontrib>Ciammaichella, M.</creatorcontrib><creatorcontrib>Pace, F.</creatorcontrib><creatorcontrib>Pesavento, R.</creatorcontrib><creatorcontrib>Piovella, C.</creatorcontrib><creatorcontrib>Rota, L.</creatorcontrib><creatorcontrib>Tiraferri, E.</creatorcontrib><creatorcontrib>Tufano, A.</creatorcontrib><creatorcontrib>Visonà, A.</creatorcontrib><creatorcontrib>Skride, A.</creatorcontrib><creatorcontrib>Belovs, A.</creatorcontrib><creatorcontrib>Moreira, M.</creatorcontrib><creatorcontrib>Ribeiro, J. L.</creatorcontrib><creatorcontrib>Sousa, M. S.</creatorcontrib><creatorcontrib>Alatri, A.</creatorcontrib><creatorcontrib>Calanca, L.</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><title>A prognostic score to identify low‐risk outpatients with acute deep vein thrombosis in the upper extremity</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Summary 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.</description><subject>Adult</subject><subject>Aged</subject><subject>anticoagulant therapy</subject><subject>Anticoagulants - adverse effects</subject><subject>Canada</subject><subject>Confidence intervals</subject><subject>Decision Support Techniques</subject><subject>deep vein thrombosis</subject><subject>Embolisms</subject><subject>Europe</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Hematology</subject><subject>Hemorrhage - chemically induced</subject><subject>hospital</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Israel</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>outcome</subject><subject>Outpatients</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - mortality</subject><subject>Pulmonary Embolism - prevention & control</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>South America</subject><subject>Thrombosis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>upper extremity</subject><subject>Upper Extremity Deep Vein Thrombosis - diagnosis</subject><subject>Upper Extremity Deep Vein Thrombosis - etiology</subject><subject>Upper Extremity Deep Vein Thrombosis - mortality</subject><subject>Upper Extremity Deep Vein Thrombosis - therapy</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kb1OwzAYRS0EgvIz8ALIEhNDwY4dOxmrCiioEkuZrcT5Ql3SOthOSzcegWfkSTAUyoQX_9yjI-t-CJ1ScknjupqF6SVlhGQ7qEdTlvVlxsTu7zln7AAdej8jhOZpQvbRQZLmGZFC9FAzwK2zTwvrg9HYa-sAB4tNBYtg6jVu7Orj7d0Z_4xtF9oimBh4vDJhigvdBcAVQIuXYBY4TJ2dl9Ybj79vgLu2BYfhNTiYm7A-Rnt10Xg4-dmP0OPN9WQ46o8fbu-Gg3Ff8zzJ-iWBvMzTugKRcp0UjEBZ6xRKIYGLTEtZyJiDLnnM0opmhCa55LSsmJaCsSN0sfFOi0a1zswLt1a2MGo0GKuvt1gE51zKJY3s-YaNNbx04IOa2c4t4vcUFTmTTFBO_ozaWe8d1FstJeprBirOQH3PILJnP8aunEO1JX9Lj8DVBliZBtb_m9T9ZLRRfgLz55I2</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Trujillo‐Santos, J.</creator><creator>Apollonio, A.</creator><creator>Sanz, O.</creator><creator>Malý, R.</creator><creator>Muñoz‐Rodriguez, F. J.</creator><creator>Serrano, J. C.</creator><creator>Monreal, M.</creator><creator>Decousus, H.</creator><creator>Prandoni, P.</creator><creator>Brenner, B.</creator><creator>Schellong, S.</creator><creator>Tzoran, I.</creator><creator>Reis, A.</creator><creator>Wells, P.</creator><creator>Papadakis, M.</creator><creator>Alibalic, A.</creator><creator>Alvarado‐Faria, A.</creator><creator>Auguet, T.</creator><creator>Ballaz, A.</creator><creator>Barrón‐Andrés, B.</creator><creator>Bascuñana, J.</creator><creator>Benítez, J. F.</creator><creator>Blanco‐Molina, A.</creator><creator>Bueso, T.</creator><creator>Cañas, A.</creator><creator>Casado, A.</creator><creator>Chaves, E. L.</creator><creator>Toro, J</creator><creator>Font, L.</creator><creator>Gallego, P.</creator><creator>García‐Ortega, A.</creator><creator>Gómez, V.</creator><creator>González, J.</creator><creator>Guijarro, R.</creator><creator>Guil, M.</creator><creator>Guirado, L.</creator><creator>Hernández‐Blasco, L.</creator><creator>Jiménez, R.</creator><creator>Lacruz, B.</creator><creator>López‐Jiménez, L.</creator><creator>López‐Montes, L.</creator><creator>López‐Reyes, R.</creator><creator>López‐Sáez, J. B.</creator><creator>Lorente, M. A.</creator><creator>Marchena, P. J.</creator><creator>Martín‐Antorán, J. M.</creator><creator>Martín‐Martos, F.</creator><creator>Morales, M. V.</creator><creator>Nauffal, D.</creator><creator>Nieto, J. A.</creator><creator>Otalora, S.</creator><creator>Otero, R.</creator><creator>Pagán, B.</creator><creator>Pedrajas, J. M.</creator><creator>Peris, M. L.</creator><creator>Pons, I.</creator><creator>Porras, J. 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L.</creator><creator>Sousa, M. S.</creator><creator>Alatri, A.</creator><creator>Calanca, L.</creator><general>Elsevier Limited</general><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-1492-9764</orcidid></search><sort><creationdate>201507</creationdate><title>A prognostic score to identify low‐risk outpatients with acute deep vein thrombosis in the upper extremity</title><author>Trujillo‐Santos, J. ; Apollonio, A. ; Sanz, O. ; Malý, R. ; Muñoz‐Rodriguez, F. J. ; Serrano, J. C. ; Monreal, M. ; Decousus, H. ; Prandoni, P. ; Brenner, B. ; Schellong, S. ; Tzoran, I. ; Reis, A. ; Wells, P. ; Papadakis, M. ; Alibalic, A. ; Alvarado‐Faria, A. ; Auguet, T. ; Ballaz, A. ; Barrón‐Andrés, B. ; Bascuñana, J. ; Benítez, J. F. ; Blanco‐Molina, A. ; Bueso, T. ; Cañas, A. ; Casado, A. ; Chaves, E. L. ; Toro, J ; Font, L. ; Gallego, P. ; García‐Ortega, A. ; Gómez, V. ; González, J. ; Guijarro, R. ; Guil, M. ; Guirado, L. ; Hernández‐Blasco, L. ; Jiménez, R. ; Lacruz, B. ; López‐Jiménez, L. ; López‐Montes, L. ; López‐Reyes, R. ; López‐Sáez, J. B. ; Lorente, M. A. ; Marchena, P. J. ; Martín‐Antorán, J. M. ; Martín‐Martos, F. ; Morales, M. V. ; Nauffal, D. ; Nieto, J. A. ; 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. ; Ruiz‐Giménez, N. ; Sabio, P. ; Soto, M. J. ; Tiberio, G. ; Tolosa, C. ; Valero, B. ; Valle, R. ; Vela, J. ; Villalobos, A. ; Villalta, J. ; Malfante, P. ; Verhamme, P. ; Vanassche, T. ; Hirmerova, J. ; Bura‐Riviere, A. ; Farge‐Bancel, D. ; Hij, A. ; Mahe, I. ; Moustafa, F. ; Quere, I. ; Babalis, D. ; Tzinieris, I. ; Braester, A. ; Barillari, G. ; Bucherini, E. ; Ciammaichella, M. ; Pace, F. ; Pesavento, R. ; Piovella, C. ; Rota, L. ; Tiraferri, E. ; Tufano, A. ; Visonà, A. ; Skride, A. ; Belovs, A. ; Moreira, M. ; Ribeiro, J. L. ; Sousa, M. S. ; Alatri, A. ; Calanca, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4928-b0e9b95fde654c2a30ebfc5eb67e468c77a7b95ecb4a305d180129741bd3c7633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>anticoagulant therapy</topic><topic>Anticoagulants - adverse effects</topic><topic>Canada</topic><topic>Confidence intervals</topic><topic>Decision Support Techniques</topic><topic>deep vein thrombosis</topic><topic>Embolisms</topic><topic>Europe</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Hematology</topic><topic>Hemorrhage - chemically induced</topic><topic>hospital</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Israel</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>outcome</topic><topic>Outpatients</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - mortality</topic><topic>Pulmonary Embolism - prevention & control</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>South America</topic><topic>Thrombosis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>upper extremity</topic><topic>Upper Extremity Deep Vein Thrombosis - diagnosis</topic><topic>Upper Extremity Deep Vein Thrombosis - etiology</topic><topic>Upper Extremity Deep Vein Thrombosis - mortality</topic><topic>Upper Extremity Deep Vein Thrombosis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trujillo‐Santos, J.</creatorcontrib><creatorcontrib>Apollonio, A.</creatorcontrib><creatorcontrib>Sanz, O.</creatorcontrib><creatorcontrib>Malý, R.</creatorcontrib><creatorcontrib>Muñoz‐Rodriguez, F. 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V.</creatorcontrib><creatorcontrib>Nauffal, D.</creatorcontrib><creatorcontrib>Nieto, J. A.</creatorcontrib><creatorcontrib>Otalora, S.</creatorcontrib><creatorcontrib>Otero, R.</creatorcontrib><creatorcontrib>Pagán, B.</creatorcontrib><creatorcontrib>Pedrajas, J. M.</creatorcontrib><creatorcontrib>Peris, M. L.</creatorcontrib><creatorcontrib>Pons, I.</creatorcontrib><creatorcontrib>Porras, J. A.</creatorcontrib><creatorcontrib>Riera‐Mestre, A.</creatorcontrib><creatorcontrib>Rivas, A.</creatorcontrib><creatorcontrib>Rodríguez‐Dávila, M. A.</creatorcontrib><creatorcontrib>Ruiz‐Giménez, N.</creatorcontrib><creatorcontrib>Sabio, P.</creatorcontrib><creatorcontrib>Soto, M. J.</creatorcontrib><creatorcontrib>Tiberio, G.</creatorcontrib><creatorcontrib>Tolosa, C.</creatorcontrib><creatorcontrib>Valero, B.</creatorcontrib><creatorcontrib>Valle, R.</creatorcontrib><creatorcontrib>Vela, J.</creatorcontrib><creatorcontrib>Villalobos, A.</creatorcontrib><creatorcontrib>Villalta, J.</creatorcontrib><creatorcontrib>Malfante, P.</creatorcontrib><creatorcontrib>Verhamme, P.</creatorcontrib><creatorcontrib>Vanassche, T.</creatorcontrib><creatorcontrib>Hirmerova, J.</creatorcontrib><creatorcontrib>Bura‐Riviere, A.</creatorcontrib><creatorcontrib>Farge‐Bancel, D.</creatorcontrib><creatorcontrib>Hij, A.</creatorcontrib><creatorcontrib>Mahe, I.</creatorcontrib><creatorcontrib>Moustafa, F.</creatorcontrib><creatorcontrib>Quere, I.</creatorcontrib><creatorcontrib>Babalis, D.</creatorcontrib><creatorcontrib>Tzinieris, I.</creatorcontrib><creatorcontrib>Braester, A.</creatorcontrib><creatorcontrib>Barillari, G.</creatorcontrib><creatorcontrib>Bucherini, E.</creatorcontrib><creatorcontrib>Ciammaichella, M.</creatorcontrib><creatorcontrib>Pace, F.</creatorcontrib><creatorcontrib>Pesavento, R.</creatorcontrib><creatorcontrib>Piovella, C.</creatorcontrib><creatorcontrib>Rota, L.</creatorcontrib><creatorcontrib>Tiraferri, E.</creatorcontrib><creatorcontrib>Tufano, A.</creatorcontrib><creatorcontrib>Visonà, A.</creatorcontrib><creatorcontrib>Skride, A.</creatorcontrib><creatorcontrib>Belovs, A.</creatorcontrib><creatorcontrib>Moreira, M.</creatorcontrib><creatorcontrib>Ribeiro, J. L.</creatorcontrib><creatorcontrib>Sousa, M. S.</creatorcontrib><creatorcontrib>Alatri, A.</creatorcontrib><creatorcontrib>Calanca, L.</creatorcontrib><creatorcontrib>RIETE Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trujillo‐Santos, J.</au><au>Apollonio, A.</au><au>Sanz, O.</au><au>Malý, R.</au><au>Muñoz‐Rodriguez, F. J.</au><au>Serrano, J. C.</au><au>Monreal, M.</au><au>Decousus, H.</au><au>Prandoni, P.</au><au>Brenner, B.</au><au>Schellong, S.</au><au>Tzoran, I.</au><au>Reis, A.</au><au>Wells, P.</au><au>Papadakis, M.</au><au>Alibalic, A.</au><au>Alvarado‐Faria, A.</au><au>Auguet, T.</au><au>Ballaz, A.</au><au>Barrón‐Andrés, B.</au><au>Bascuñana, J.</au><au>Benítez, J. F.</au><au>Blanco‐Molina, A.</au><au>Bueso, T.</au><au>Cañas, A.</au><au>Casado, A.</au><au>Chaves, E. L.</au><au>Toro, J</au><au>Font, L.</au><au>Gallego, P.</au><au>García‐Ortega, A.</au><au>Gómez, V.</au><au>González, J.</au><au>Guijarro, R.</au><au>Guil, M.</au><au>Guirado, L.</au><au>Hernández‐Blasco, L.</au><au>Jiménez, R.</au><au>Lacruz, B.</au><au>López‐Jiménez, L.</au><au>López‐Montes, L.</au><au>López‐Reyes, R.</au><au>López‐Sáez, J. B.</au><au>Lorente, M. A.</au><au>Marchena, P. J.</au><au>Martín‐Antorán, J. M.</au><au>Martín‐Martos, F.</au><au>Morales, M. V.</au><au>Nauffal, D.</au><au>Nieto, J. A.</au><au>Otalora, S.</au><au>Otero, R.</au><au>Pagán, B.</au><au>Pedrajas, J. M.</au><au>Peris, M. L.</au><au>Pons, I.</au><au>Porras, J. A.</au><au>Riera‐Mestre, A.</au><au>Rivas, A.</au><au>Rodríguez‐Dávila, M. A.</au><au>Ruiz‐Giménez, N.</au><au>Sabio, P.</au><au>Soto, M. J.</au><au>Tiberio, G.</au><au>Tolosa, C.</au><au>Valero, B.</au><au>Valle, R.</au><au>Vela, J.</au><au>Villalobos, A.</au><au>Villalta, J.</au><au>Malfante, P.</au><au>Verhamme, P.</au><au>Vanassche, T.</au><au>Hirmerova, J.</au><au>Bura‐Riviere, A.</au><au>Farge‐Bancel, D.</au><au>Hij, A.</au><au>Mahe, I.</au><au>Moustafa, F.</au><au>Quere, I.</au><au>Babalis, D.</au><au>Tzinieris, I.</au><au>Braester, A.</au><au>Barillari, G.</au><au>Bucherini, E.</au><au>Ciammaichella, M.</au><au>Pace, F.</au><au>Pesavento, R.</au><au>Piovella, C.</au><au>Rota, L.</au><au>Tiraferri, E.</au><au>Tufano, A.</au><au>Visonà, A.</au><au>Skride, A.</au><au>Belovs, A.</au><au>Moreira, M.</au><au>Ribeiro, J. L.</au><au>Sousa, M. S.</au><au>Alatri, A.</au><au>Calanca, L.</au><aucorp>RIETE Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prognostic score to identify low‐risk outpatients with acute deep vein thrombosis in the upper extremity</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2015-07</date><risdate>2015</risdate><volume>13</volume><issue>7</issue><spage>1274</spage><epage>1278</epage><pages>1274-1278</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Summary 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.</abstract><cop>England</cop><pub>Elsevier Limited</pub><pmid>25980766</pmid><doi>10.1111/jth.13008</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-1492-9764</orcidid><oa>free_for_read</oa></addata></record>
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subjects	Adult Aged anticoagulant therapy Anticoagulants - adverse effects Canada Confidence intervals Decision Support Techniques deep vein thrombosis Embolisms Europe Female Health risk assessment Hematology Hemorrhage - chemically induced hospital Human health and pathology Humans Israel Life Sciences Male Middle Aged outcome Outpatients Predictive Value of Tests Pulmonary Embolism - diagnosis Pulmonary Embolism - etiology Pulmonary Embolism - mortality Pulmonary Embolism - prevention & control Registries Risk Assessment Risk Factors South America Thrombosis Time Factors Treatment Outcome upper extremity Upper Extremity Deep Vein Thrombosis - diagnosis Upper Extremity Deep Vein Thrombosis - etiology Upper Extremity Deep Vein Thrombosis - mortality Upper Extremity Deep Vein Thrombosis - therapy
title	A prognostic score to identify low‐risk outpatients with acute deep vein thrombosis in the upper extremity
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