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A Practical Guide to Haemostasis


Venous Thromboembolic Disease [VTED] & Bleeding:
The VTE-BLEED Score

Introduction

The VTE-BLEED score was developed to identify patients on anticoagulation for VTED and who were at increased risk of bleeding.  The original study was based on a post-hoc analysis of patients enrolled in various trials evaluating Dabigatran [a direct Thrombin inhibitor] versus standard treatment with Warfarin and subsequent studies have evaluated patients on Rivaroxaban [a direct Factor Xa inhibitor].

The algorithm is summarised below:

The VTE Bleed Score:


Select Criteria:

Active Cancer
Yes
2 Points
Male Patient with Uncontrolled Hypertension
[Systolic BP ≥140mm Hg]
Yes
1 Point
Anaemia
[Hb <130g/L Men.  Hb <120g/L Women]
Yes
1.5 Points
History of Bleeding
[Major or non-major clinically relevant bleeding]
Yes
1.5 Points
Renal Dysfunction
[CrCl 30-60ml/min]
Yes
1.5 Points
Age ≥60 yrs
Yes
1.5 Points


Score
[Max score 9]

VTE-BLEED Score
<2 Low bleeding risk
≥2 High bleeding risk


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