Background: Management of venous thromboembolism (VTE) after the initial 3 months anticoagulation remains controversial. Determining which patients may benefit from indefinite anticoagulation remains a key question; risk prediction tools (e.g. DASH score, Vienna score and HERDOO2) have been used to help determine recurrence risk. The DASH score comprises the D- dimer 1 month after stopping anticoagulation (+2 if positive), age ≤50 (+1), sex (+1 if male) and use of hormonal therapy (- 2). A score ≤1 predicts a relatively low recurrence risk (3.1% annually; 95% confidence interval (CI) 2.3- 3.9) and has been used to stop anticoagulation where otherwise there is clinical equipoise.
Aims: To provide long-term data on patients treated with the DASH score with unprovoked VTE (proximal deep vein thrombosis (DVT) & pulmonary embolism (PE)), who had a score ≤1 and that didn’t have long-term anticoagulation.
Methods: Single- centre retrospective service evaluation of patients seen in the thrombophilia clinic between 1.1.2013- 31.12.2016. The project was registered with the hospital audit department. The outcome of these patients was determined. The census date was 31.12.20, recurrent VTE or death (whichever was soonest).
Results: 145 patients were included. Mean age at index VTE was 62 years (standard deviation (SD) 15) and 52.4% patients were male. 1 patient had a previous history of provoked VTE. 5.5% patients continued low dose aspirin after anticoagulation was stopped. 10.3% patients had hormone provoked VTE. Mean weight (available for 118 patients) was 86.9kg (SD 20.2). Median follow-up 4.7 years. In 635 patient years follow-up there were 39 recurrences; 6.1/100 patient years. 15 recurrences were as DVT, 22 as PE and 2 were DVT/PE.
Conclusions: A DASH score ≤1 was insufficient to determine a threshold at which anticoagulation could be stopped; this may be due to other risk factors (e.g. weight and post-thrombotic syndrome) not accounted for in the tool.
To cite this abstract in AMA style:Banerjee A, Berks M, Hu M, Umeria R, Zhou Y, WT. DASH Score for Prediction of Recurrent Venous Thromboembolism: Updated Long-term Outcomes from a Single-centre [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/dash-score-for-prediction-of-recurrent-venous-thromboembolism-updated-long-term-outcomes-from-a-single-centre/. Accessed September 23, 2021.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/dash-score-for-prediction-of-recurrent-venous-thromboembolism-updated-long-term-outcomes-from-a-single-centre/