Practical-Manual-Scores-Algorithms-Haemostasis-Thrombosis

Deep Vein Thrombosis and Pulmonary Embolismwhich a perpendicular line is drawn to this value, which gives the cumulated riskat one year and, by drawing another perpendicular line, the cumulative risk atfive years. For example: A man with a proximal DVT and a D-dimer of 400 μg/Lwill score 60 points for gender, 70 for proximal thrombosis and 46 points forD-dimer, totalizing 176 points, which corresponds to a probability of recurrenceof 5.1% and 18.5%, at one and five years, respectively.DASH scoreFeatureScoreAbnormal D-dimer(measured one month after stopping anticoagulation)+2Age ≤ 50 +1Male +1Hormonal therapy at onset of VTE (among women) –2ProbabilityLow ≤ 1High > 1DASH: D-dimer, Age, Sex, HormonesInterpretationThis model classifies DVT or PE recurrence risk as low (annual incidencearound 3%) if the score is 0 or 1, or high (annual incidence around 9%) if it ishigher than 1. Of note, D-dimer measurement is performed after withdrawal ofanticoagulation (≅ 30 days).References• Eichinger S, Heinze G, Jandeck LM, et al. Risk assessment of recurrence inpatients with unprovoked deep-vein thrombosis or pulmonary embolism: theVienna prediction model. Circulation. 2010;121:1630-6.• Tosetto A, Iorio A, Marcucci M, et al. Predicting disease recurrence in patientswith previous unprovoked venous thromboembolism: a proposed prediction score(DASH). J Thromb Haemost. 2012;10:1019-25.18