Galeano Valle, FranciscoAlonso Beato, RubénMoragón Ledesma, SergioPire García, TatianaHuergo Fernández, OlayaOrdieres Ortega, LucíaOblitas, Crhistian MarioÁlvarez-Sala Walther, Luis AntonioDemelo Rodríguez, Pablo2025-12-182025-12-182025-02Galeano-Valle F, Alonso-Beato R, Moragón-Ledesma S, Pire-García T, Huergo-Fernández O, Ordieres-Ortega L, Oblitas CM, Walther LAA, Demelo-Rodríguez P. External validation of a prognostic score to identify low-risk outpatients with acute deep venous thrombosis in the lower limbs. Eur J Intern Med. 2025 Feb;132:76-83. doi: 10.1016/j.ejim.2024.10.007. Epub 2024 Oct 15. PMID: 39406608.0953-620510.1016/j.ejim.2024.10.007https://hdl.handle.net/20.500.14352/129316Background: Current clinical guidelines suggest home treatment for patients diagnosed with acute deep venous thrombosis (DVT). A prognostic score has been proposed to identify low-risk patients; however, its validation remains limited. Method: This prospective observational study aimed to externally validate the prognostic score in selecting low-risk outpatients with acute DVT in the lower limbs. Consecutive outpatients diagnosed with acute DVT in a tertiary hospital were included. The score included 6 variables: heart failure, kidney failure, recent major bleeding, altered platelet count, immobilization, and cancer. The primary outcome was the incidence of a composite outcome, including confirmed diagnosis of PE, major bleeding, or all-cause death at 7 days. Patients meeting zero criteria were considered low risk. Results: Among the 1035 patients included, 485 (46.9 %) met zero criteria. Of these, 0.2 % (95 % CI 0.0-1.1 %) and 0.4 % (95 % CI, 0.0-1.5 %) patients experienced the composite outcome at 7 and 30 days, respectively. Among patients who met 1 or more criteria for admission, 344 patients (62.5 %) were discharged. Among these, the composite outcome at 7 and 30 days occurred in 2 (0.6 %) and 5 (1.4 %) patients, respectively. The C-statistics of the score were 0.68 (95 % CI, 0.57-0.79) and 0.69 (95 % CI, 0.64-0.76) at 7 and 30 days, respectively. Conclusion: This study demonstrates the efficacy of the prognostic score in identifying low-risk outpatients with acute DVT. It also suggests that a considerable proportion of patients with acute DVT may benefit from outpatient treatment despite having some risk criteria, highlighting the potential for optimizing ambulatory care pathways.engjournal article1879-0828https://doi.org/10.1016/j.ejim.2024.10.00739406608https://www.sciencedirect.com/science/article/pii/S0953620524004175?via%3Dihubhttps://pubmed.ncbi.nlm.nih.gov/39406608/restricted accessDeep venous thrombosisHospitalizationMajor bleedingMortalityOutpatient managementPulmonary embolismCiencias Biomédicas32 Ciencias Médicas