DASH Prediction Score for Recurrent VTE
Predicts the annual risk of recurrent VTE after discontinuing anticoagulation following a first unprovoked VTE event, to guide duration of therapy
Score interpretation
DASH ≤ 1: Low annual recurrence risk (~3.1%/year after stopping anticoagulation).
→ Stopping anticoagulation after 3–6 months may be appropriate for many patients. Discuss patient preferences, bleeding risk, and individual circumstances.
DASH = 2: Intermediate annual recurrence risk (~6.4%/year).
→ Individualise anticoagulation duration. Weigh recurrence risk vs bleeding risk. Consider extended therapy with patient involvement.
DASH ≥ 3: High annual recurrence risk (~12.3%/year).
→ Extended indefinite anticoagulation likely warranted. DOAC preferred (apixaban 2.5mg bd or rivaroxaban 10mg od extended prophylaxis). Haematology/respiratory review.
Interpretation bands for the DASH Score. Apply clinical judgement and local guidance.
References
- Tosetto A, et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: a proposed prediction score (DASH). J Thromb Haemost. 2012;10(6):1019–1025.
Related
Curated clinical cross-links plus same-class fallbacks.
- Atracurium Besilate · Non-depolarising Neuromuscular Blocking Agent (Intermediate Duration)
- Bivalirudin (PCI Anticoagulation) · Direct Thrombin Inhibitor / PCI
- Bivalirudin · Anticoagulation
- Naseptin Nasal Cream · Nasal Decolonisation / Recurrent Epistaxis
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Ziprasidone · Atypical Antipsychotic — D2/5-HT2A Antagonist (Low Metabolic Risk)
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The DASH Score is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.