Evaluation of Venous Thromboembolism Recurrence Scores in an Unprovoked Pulmonary Embolism Population: a post-hoc analysis of the PADIS-PE trial.

Abstract Introduction We aimed to validate the HERDOO2, DASH and Updated Vienna recurrent venous thromboembolism prediction models in a population composed entirely of first unprovoked pulmonary embolism and analyzed the impact of the addition of pulmonary vascular obstruction index (PVOI) on score accuracy. Methods Analyses were based on the double-blind randomized “PADIS-PE” trial including 371 unprovoked pulmonary embolism patients initially treated during 6 months, successively randomized to receive an additional 18-months of warfarin or placebo, and subsequently followed-up for two years. Results The HERDOO2, DASH and Updated Vienna scores displayed c-statistics of 0.61 (95%CI 0.54-0.68), 0.60 (95%CI 0.53-0.66) and 0.58 (95%CI 0.51-0.66) respectively. Only the HERDOO2 score identified low recurrence risk patients ( Conclusions In patients with a first unprovoked pulmonary embolism, the HERDOO2 score is able to identify patients with a low recurrence risk after treatment discontinuation. Addition of PVOI improves accuracy of all scores. Clinical Trials Registration URL: http://www.controlled-trials.com . Unique identifier: NCT00740883.