VTE-BLEED Score
Estimates major bleeding risk in patients on anticoagulation for VTE to guide duration of treatment.
Score interpretation
In the Hokusai-VTE validation, major bleeding after day 30 occurred in 0.5% (Klok 2017).
→ Bleeding risk does not argue against extended anticoagulation when the recurrence risk is high; reassess regularly.
About four-fold higher risk of major bleeding during stable anticoagulation (2.0% vs 0.5% after day 30 in Hokusai-VTE).
→ Weigh against the recurrence risk when deciding on extended anticoagulation; correct modifiable factors (blood pressure, anaemia, concomitant antiplatelets or NSAIDs) and review more often.
Interpretation bands for the VTE-BLEED. Apply clinical judgement and local guidance.
References
- Klok FA, Hösel V, Clemens A, et al. Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment. Eur Respir J. 2016;48(5):1369–1376.
- Klok FA, Barco S, Konstantinides SV. External validation of the VTE-BLEED score for predicting major bleeding in stable anticoagulated patients with venous thromboembolism. Thromb Haemost. 2017;117(6):1164–1170.
Related
Curated clinical cross-links plus same-class fallbacks.
- Warfarin · Anticoagulant
- Enoxaparin (LMWH) · Anticoagulant
- Bivalirudin (PCI Anticoagulation) · Direct Thrombin Inhibitor / PCI
- Prothrombin Complex Concentrate (PCC) · Coagulation Factor Concentrate — Warfarin Reversal
- Vasopressin / Terlipressin · Vasopressin Analogue — Vasodilatory Shock / Variceal Bleeding
- Bivalirudin · Anticoagulation
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.