Key result
CHAP model identifies unprovoked VTE patients facing ~255% greater major bleeding risk during extended anticoagulation.
Why the study?
No clinical prediction model had been specifically developed or validated to identify patients with unprovoked VTE at high risk of major bleeding during extended anticoagulation.
Can the newly derived CHAP model and modified existing clinical scores accurately identify patients with unprovoked VTE at high risk of major bleeding during extended anticoagulation?
Cohort (n=2,516)
Yes
Can the newly derived CHAP model and modified existing clinical scores accurately identify patients with unprovoked VTE at high risk of major bleeding during extended anticoagulation?
Absolute Event Rate: 3.9% vs 1.1%
Modified ACCP, VTE-BLEED, and HAS-BLED scores, as well as the newly derived CHAP model, can help identify patients with unprovoked VTE at high risk of major bleeding who may benefit from discontinuing extended anticoagulation.
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May support CHAP for bleeding risk stratification in unprovoked VTE; leaves open prospective validation before practice change.
Wells et al. (2022) conducted a cohort in unprovoked venous thromboembolism (VTE) (n=2,516). CHAP model vs. Modified ACCP, RIETE, VTE-BLEED, HAS-BLED, and outpatient bleeding index scores was evaluated on major bleeding. The newly derived CHAP model identified patients with unprovoked VTE at high risk of major bleeding during extended anticoagulation (3.9 vs 1.1 events per 100 person-years for high vs non-high risk).
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