Application of the RIETE score to identify low-risk patients with pulmonary embolism: From the COMMAND VTE Registry

Thromb Res. 2023 Dec:232:35-42. doi: 10.1016/j.thromres.2023.10.015. Epub 2023 Oct 24.

Abstract

Background: The RIETE score could be specifically useful for identification of low-risk pulmonary embolism (PE) patients for home treatment. However, the external validation of the RIETE score has been limited.

Methods: The COMMAND VTE Registry is a multicenter registry enrolling consecutive patients with acute symptomatic venous thromboembolism (VTE). The current study population consisted of 1479 patients with acute PE, who were divided into 2 groups; RIETE scores of 0 (N = 260) and ≥ 1 (N = 1219).

Results: The cumulative 10-day and 30-day incidences of a composite endpoint of all-cause death, recurrent PE, or major bleeding were lower in patients with the RIETE score of 0 than in those with the RIETE score of ≥1 (10-day: 0.4 % vs. 6.7 %, P < 0.001, and 30-day: 0.4 % vs. 10.0 %, P < 0.001). The area under the receiver-operating characteristic curve (AUC) in the RIETE score for the 10-day composite endpoint showed numerically better predictive ability than that in the sPESI score (0.77 vs. 0.73, P = 0.07), and the AUC in the RIETE score for the 30-day composite endpoint showed significantly better predictive ability than that in the sPESI score (0.77 vs. 0.71, P = 0.003).

Conclusions: The RIETE score was well validated in the current large real-world registry. The RIETE score of 0 could identify patients with reasonably low risks of the 10-day and 30-day composite endpoint of all-cause death, recurrent PE, or major bleeding.

Keywords: Bleeding; Mortality; Pulmonary embolism; RIETE; Recurrence; Risk.

Publication types

  • Multicenter Study

MeSH terms

  • Anticoagulants
  • Hemorrhage / diagnosis
  • Hemorrhage / epidemiology
  • Hemorrhage / etiology
  • Humans
  • Pulmonary Embolism* / epidemiology
  • Recurrence
  • Registries
  • Risk
  • Risk Factors
  • Venous Thromboembolism* / diagnosis
  • Venous Thrombosis*

Substances

  • Anticoagulants