A risk score for prediction of recurrence in patients with unprovoked venous thromboembolism (DAMOVES)

摘要: Abstract Background In patients with unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulation is anchored on estimating risk disease recurrence. We aimed to develop a simple assessment model that improves prediction recurrence risk. Methods prospective cohort study, 398 first VTE were followed up for median 21.3 months after discontinuation anticoagulation. excluded strong thrombophilic defect. Preselected clinical and laboratory variables analyzed based independent confirmation impact risk, simplicity assessment, reproducibility. Multivariable Cox regression analysis was used score subsequently internally validated by bootstrap analysis. Results A total 65 (16.3%) had recurrent VTE. all patients, recurred spontaneously. Male sex (HR = 2.89 [95% CI 1.21–6.90] P = 0.016), age (HR = 1.0310 per additional decade 1.01–1.07] P = 0.011), obesity (HR = 3.92 1.75–8.75] P = 0.0001), varicose veins (HR = 4.14 1.81–9.43] abnormal D-dimer during (HR = 13.66 4.74–39.37] high factor VIII coagulant activity (HR = 1.01 1.00–1.02] P = 0.028) heterozygous V Leiden and/or Prothrombin G20210A mutation (HR = 13.86 5.87–32.75] P = 0.0001) related higher Using these variables, we developed nomogram [hereafter referred as DAMOVES (D-dimer, Age, Mutation, Obesity, Varicose veins, Eight, Sex)] in an individual patient. Conclusions The can be predict may useful decide whether anticoagulant therapy should continued indefinitely or stopped initial treatment period at least 3 months.