BACKGROUND: No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS: We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS: As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS: Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.

Department of Angiology and Vascular Surgery Complejo Asistencial de Salamanca Salamanca Spain

Department of Angiology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland

Department of Internal Medicine Complejo Hospitalario Universitario de Cartagena Murcia Spain

Department of Internal Medicine Hospital de la Agencia Valenciana de Salud Vega Baja Alicante Spain

Department of Internal Medicine Hospital de Montilla Córdoba Spain

Department of Internal Medicine Hospital General Universitario Gregorio Marañón Madrid Spain

Department of Internal Medicine Hospital Universitari Germans Trias i Pujol Badalona Barcelona Spain

Department of Internal Medicine Ospedale S Maria della Misericordia Udine Italy

Department of Internal Medicine University Hospital Plzen Plzen Czech Republic

Department of Pneumonology Hospital San Pedro Logroño La Rioja Spain

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