Predicting recurrence after unprovoked venous thromboembolism: prospective validation of the updated Vienna Prediction Model.
The updated Vienna Prediction Model for estimating recurrence risk after an unprovoked venous thromboembolism (VTE) has been developed to identify individuals at low risk for VTE recurrence in whom anticoagulation (AC) therapy may be stopped after 3 months. We externally validated the accuracy of the model to predict recurrent VTE in a prospective multicenter cohort of 156 patients aged ≥65 years with acute symptomatic unprovoked VTE who had received 3 to 12 months of AC. Patients with a predicted 12-month risk within the lowest quartile based on the updated Vienna Prediction Model were classified as low risk. The risk of recurrent VTE did not differ between low- vs higher-risk patients at 12 months (13% vs 10%; P = .77) and 24 months (15% vs 17%; P = 1.0). The area under the receiver operating characteristic curve for predicting VTE recurrence was 0.39 (95% confidence interval [CI], 0.25-0.52) at 12 months and 0.43 (95% CI, 0.31-0.54) at 24 months. In conclusion, in elderly patients with unprovoked VTE who have stopped AC, the updated Vienna Prediction Model does not discriminate between patients who develop recurrent VTE and those who do not. This study was registered at www.clinicaltrials.gov as #NCT00973596.
Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland;
Tobias
T
Tritschler
Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland; Department of General Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland; and.
Marie
M
Méan
Clinical Trials Unit Bern, Department of Clinical Research, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Andreas
A
Limacher
Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland;
Nicolas
N
Rodondi
Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland;
Drahomir
D
Aujesky
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000453:epidemiology*
D000925:Anticoagulants