{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T17:46:24Z","timestamp":1774115184868,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T00:00:00Z","timestamp":1452729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Outpatient treatment of acute venous thromboembolism (VTE) requires the selection of patients with a low risk of bleeding during the first few weeks of anticoagulation. The accuracy of four systems, originally derived for predicting bleeding in VTE treated with vitamin K antagonists (VKAs), was assessed in VTE patients treated with rivaroxaban.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients treated with rivaroxaban in the multinational EINSTEIN deep vein thrombosis (DVT) and pulmonary embolism (PE) trials were included. Major bleeding was defined as \u22652\u00a0g\/dL drop in hemoglobin or \u22652\u2010unit blood transfusion, bleeding in critical area, or bleeding contributing to death. The authors examined the incidence of major bleeding in patients with low\u2010risk assignment by the systems of Ruiz\u2010Gimenez et\u00a0al. (score\u00a0= 0 to 1), Beyth et\u00a0al. (score\u00a0=\u00a00), Kuijer et\u00a0al. (score\u00a0=\u00a00), and Landefeld and Goldman. (score\u00a0=\u00a00). For clinical relevance, the definition of low risk for all scores except Kuijer includes all patients\u00a0&lt;\u00a065\u00a0years with no prior bleeding history and no comorbid conditions (current cancer, renal insufficiency, diabetes mellitus, anemia, prior stroke, or myocardial infarction).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4,130 patients (1,731 with DVT only, 2,399 with PE with or without DVT) were treated with rivaroxaban for a mean (\u00b1SD) duration of 207.6 (\u00b195.9) days. Major bleeding occurred in 1.0% (40 of 4,130; 95% confidence interval [CI]\u00a0=\u00a00.7% to 1.3%) overall. Rates of major bleeding for low\u2010risk patients during the entire treatment period were similar: Ruiz\u2010Gimenez et\u00a0al., 12 of 2,622 (0.5%; 95% CI\u00a0=\u00a00.2% to 0.8%); Beyth et\u00a0al., nine of 2,249 (0.4%; 95% CI\u00a0=\u00a00.2% to 0.8%); Kuijer et\u00a0al., four of 1,186 (0.3%; 95% CI\u00a0=\u00a00.1% to 0.9%); and Landefeld and Goldman, 11 of 2,407 (0.5%; 95% CI\u00a0=\u00a00.2% to 0.8%). At 30\u00a0days, major bleed rates for low\u2010risk patients were as follows: Ruiz\u2010Gimenez et\u00a0al., five of 2,622 (0.2%; 95% CI\u00a0=\u00a00.1% to 0.4%); Beyth et\u00a0al., five of 2,249 (0.2%; 95% CI\u00a0=\u00a00.1% to 0.5%); Kuijer et\u00a0al., three of 1,186 (0.3%; 95% CI\u00a0=\u00a00.1% to 0.7%); and Landefeld and Goldman, seven of 2,407 (0.3%; 95% CI\u00a0=\u00a00.1% to 0.6%). No low\u2010risk patient had a fatal bleed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Four scoring systems that use criteria obtained in routine clinical practice, derived to predict low bleeding risk with VKA treatment for VTE, identified patients with less than a 1% risk of major bleeding during full\u2010course treatment with rivaroxaban.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12865","type":"journal-article","created":{"date-parts":[[2016,1,15]],"date-time":"2016-01-15T03:28:22Z","timestamp":1452828502000},"page":"144-150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Comparison of Four Bleeding Risk Scores to Identify Rivaroxaban\u2010treated Patients With Venous Thromboembolism at Low Risk for Major Bleeding"],"prefix":"10.1111","volume":"23","author":[{"given":"Jeffrey A.","family":"Kline","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine and Department of Cellular and Integrative Physiology Indiana University School of Medicine Indianapolis IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Respiratory Department and Medicine Department Ramon y Cajal Hospital IRYCIS Madrid Spain"},{"name":"Alcala de Henares University Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Mark","family":"Courtney","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University School of Medicine Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Ianus","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Medical Affairs (Cardiovascular and Metabolism) Raritan NJ"},{"name":"Janssen Research and Development LLC Raritan NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Cao","sequence":"additional","affiliation":[{"name":"Janssen Research and Development LLC Raritan NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthonie W.A.","family":"Lensing","sequence":"additional","affiliation":[{"name":"Bayer HealthCare AG Leverkusen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin H.","family":"Prins","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center Maastricht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip S.","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Ottawa and the Ottawa Hospital Research Institute Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,1,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.05.041"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2013.08.012"},{"key":"e_1_2_7_4_1","first-page":"CD010019","article-title":"Outpatient versus inpatient treatment for acute pulmonary embolism","volume":"11","author":"Yoo HH","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12711"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(89)80689-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(98)00198-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.5.457"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH08-03-0193"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1007903"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1113572"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-9560-11-21"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201411-548OC"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04648.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2013-204762"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.12865","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.12865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T19:58:37Z","timestamp":1695758317000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.12865"}},"subtitle":[],"editor":[{"given":"Kennon","family":"Heard","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2016,1,14]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/acem.12865"],"URL":"https:\/\/doi.org\/10.1111\/acem.12865","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,14]]},"assertion":[{"value":"2015-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}