Table 3.
Recurrence risk prediction models after a first unprovoked VTE
| Study | Type of study | Predictors of VTE recurrence (vs no risk factor) | VTE recurrence risk or RR, HR (95% CI), or score in model |
|---|---|---|---|
| Rodger et al 2008 (HERDOO2 derivation study)42 | Prospective cohort study | (1) Postthrombotic syndrome (HER) | (1) Men: RR 2.54 (1.48-4.38) |
| (2) Elevated D-dimer on anticoagulation | (1) Women: RR 3.04 (1.40-6.60) | ||
| (3) Obesity | (2) Women: RR 3.02 (1.41-6.51) | ||
| (4) Older age | (3) Women: RR 2.33 (1.14-4.74) | ||
| (4) Women: RR 2.26 (1.12-4.56) | |||
| Eichinger et al 2010 (Vienna prediction model)19 | Prospective cohort study | Male sex | HR 1.91 (1.37-2.67) |
| Proximal vs distal DVT | HR 2.76 (1.57-4.84) | ||
| PE vs distal DVT | HR 3.15 (1.83-5.44) | ||
| Elevated D-dimer | HR 1.24 (1.05-1.45) | ||
| Tosetto et al 2012 (DASH score)20 | Patient-level meta-analysis | Elevated D-dimer | Score 2 |
| Young age* | Score 1 | ||
| Male sex | Score 1 | ||
| Hormone use | Score −2 | ||
| Rodger et al 2017 (REVERSE; HERDOO2 rule)18 | Prospective cohort management study | Low-HERDOO2-risk women | 3% per 100 patient years (1.8-4.8) |
| Men and high-risk women: | 1.6% per 100 patient years (1.1-2.3) | ||
| Continued AC | 8.1% per 100 patient years (5.2-11.9) | ||
| D/C AC | 7.4% per 100 patient years (3.0-15.2) | ||
| High-HERDOO-risk women who D/C AC |
Low HERDOO2 risk, ≤1 HERDOO2 criteria (hyperpigmentation, edema, or redness [HER] in either leg; D-dimer level ≥ 250 μg/L; obesity with body mass index ≥ 30 kg/m2; or older age, ≥ 65 years).
AC, anticoagulation; D/C, discontinued; HR, hazard ratio; RR, relative risk.
*
First quartile (14-47 years) vs fourth quartile (>72 years).