⏳ Venous Thromboembolism Anticoagulation Duration Decision
UseUse to set anticoagulation duration: short course for major transient triggers, indefinite for cancer or recu…
SourceStevens SM, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline. Ch…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with suspected acute PE when deciding whether to test further, and risk stratification after confirmation.
- Who it is not for
- PERC must not rule out PE when clinical probability is not already low. Confirmed PE does not return to PERC. PERC is not an atrial-fibrillation tool and not a treatment page.
- Formula and variables
- Wells PE and revised Geneva estimate clinical probability; the version stays as on this page. PERC is used only when probability is already low, to see whether testing can stop. BOVA is only for normal blood pressure. Hestia only answers outpatient eligibility. No new score.
- Result → next step
- If probability is low and every PERC item is negative, stop further PE testing; otherwise test. The treatment column stays empty before confirmation. After confirmation, duration opens the anticoagulation-duration page. That link is not hung on PERC. Numeric dose waits for age, weight, renal function, and pregnancy.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.
- Guideline
- 2019 ESC PE
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Methodology · worked example, guidelines & full notes
Unprovoked VTE tips toward extended anticoagulation unless bleeding risk is high, where a 3-month course with possible aspirin is preferred. (original synthesis · not guideline verbatim)
When to use
Use to set anticoagulation duration: short course for major transient triggers, indefinite for cancer or recurrence, and bleeding-risk-dependent for unprovoked VTE.
How it works
Major transient → 3 months. Minor transient → ≥ 3 months, individualized. Cancer → until inactive. Recurrent → extended/indefinite. Unprovoked → extended if low-moderate bleeding (reduced-dose DOAC), stop at 3 months if high bleeding.
Key points
- Unprovoked VTE tips toward extended anticoagulation unless bleeding risk is high, where a 3-month course with possible aspirin is preferred. (original synthesis · not guideline verbatim)
- All VTE receives at least 3 months of anticoagulation regardless of provoking factor.
- Extended courses are periodically reassessed for bleeding risk, benefit, and preference.
References
- [Guideline / primary source]Stevens SM, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline. Chest 2021.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Provoking-factor type | Unprovoked |
|---|---|
| Bleeding risk | Low-moderate |
→Anticoagulation durationExtended anticoagulation (no fixed stop date)
- Decision：Unprovoked VTE carries high recurrence risk with low-moderate bleeding risk, so extended anticoagulation (no fixed stop date) is recommended, and a reduced-dose DOAC may be considered (apixaban or rivaroxaban).
- General rule：All VTE is anticoagulated at least 3 months; those on extended anticoagulation should periodically (e.g. yearly) reassess bleeding risk, benefit, and patient preference
- Bleeding risk：Low-moderate bleeding risk: can tolerate extended anticoagulation
| Provoking-factor type | Major transient (surgery/trauma/prolonged immobilization) |
|---|---|
| Bleeding risk | Low-moderate |
→Anticoagulation durationStop anticoagulation after 3 months
- Decision：Caused by a major transient factor (surgery, trauma, prolonged immobilization), the recurrence risk after stopping is low, and 3 months suffices.
- General rule：All VTE is anticoagulated at least 3 months; those on extended anticoagulation should periodically (e.g. yearly) reassess bleeding risk, benefit, and patient preference
- Bleeding risk：Low-moderate bleeding risk: can tolerate extended anticoagulation
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Venous Thromboembolism Anticoagulation Duration Decision?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Venous Thromboembolism Anticoagulation Duration Decision upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Venous Thromboembolism Anticoagulation Duration Decision calculated in practice? Can you show a worked example?
- Inputs: Provoking-factor type Unprovoked, Bleeding risk Low-moderate → Result: Anticoagulation duration Extended anticoagulation (no fixed stop date)（Decision: Unprovoked VTE carries high recurrence risk with low-moderate bleeding risk, so extended anticoagulation (no fixed stop date) is recommended, and a reduced-dose DOAC may be considered (apixaban or rivaroxaban)., General rule: All VTE is anticoagulated at least 3 months; those on extended anticoagulation should periodically (e.g. yearly) reassess bleeding risk, benefit, and patient preference, Bleeding risk: Low-moderate bleeding risk: can tolerate extended anticoagulation） Inputs: Provoking-factor type Major transient (surgery/trauma/prolonged immobilization), Bleeding risk Low-moderate → Result: Anticoagulation duration Stop anticoagulation after 3 months（Decision: Caused by a major transient factor (surgery, trauma, prolonged immobilization), the recurrence risk after stopping is low, and 3 months suffices., General rule: All VTE is anticoagulated at least 3 months; those on extended anticoagulation should periodically (e.g. yearly) reassess bleeding risk, benefit, and patient preference, Bleeding risk: Low-moderate bleeding risk: can tolerate extended anticoagulation）