Pulmonary embolism
DASH Score
Patient-level meta-analysis score (Tosetto 2012): abnormal D-dimer after stopping anticoagulation, Age ≤ 50, Sex (male) and Hormone use at the time of the VTE (women). Predicts annual recurrence after stopping treatment.
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Criteria
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- Validated for first unprovoked VTE after at least 3 months of anticoagulation. The D-dimer requires stopping treatment first.
Total score
0
Low recurrence risk
Recurrence ≈ 3.1% per year after stopping
Decision guide
Stopping anticoagulation after 3–6 months is reasonable, especially if bleeding risk is not low. Discuss patient preference.
Ranges: -2–1 Low recurrence risk2 Intermediate recurrence risk3–4 High recurrence risk
References
- Tosetto A, et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: a proposed prediction score (DASH). J Thromb Haemost 2012;10:1019-1025.
- Konstantinides SV, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism. Eur Heart J 2020;41:543-603.
More in Pulmonary embolism
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Bleeding risk on anticoagulation
Anticoagulation duration & recurrence
Cancer-associated VTE