Pulmonary embolism
Ottawa Score
Four-item score (Louzada 2012): female sex, lung cancer, previous VTE (+1 each), breast cancer (−1) and TNM stage I (−2). Identifies patients with cancer-associated VTE at high risk of recurrence despite anticoagulation.
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Cancer type
TNM stage
Additional criteria
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Total score
0
Low recurrence risk
Recurrent VTE ≈ 4.5% at 6 months
Decision guide
Standard cancer-associated VTE treatment for at least 6 months: LMWH, or edoxaban/rivaroxaban/apixaban when the bleeding risk is acceptable (caution in GI and genitourinary cancer). Continue while the cancer is active (ESC 2019 IIa).
2 sections are still unanswered — counted as 0 points.
Ranges: -3–0 Low recurrence risk1–3 High recurrence risk
References
- Louzada ML, et al. Development of a clinical prediction rule for risk stratification of recurrent venous thromboembolism in patients with cancer-associated venous thromboembolism. Circulation 2012;126:448-454.
- Delluc A, et al. Accuracy of the Ottawa score in risk stratification of recurrent venous thromboembolism in patients with cancer-associated venous thromboembolism: a systematic review and meta-analysis. Haematologica 2020;105:1436-1442.
- 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
PE diagnosis
PE prognosis & management
Bleeding risk on anticoagulation
Anticoagulation duration & recurrence
Cancer-associated VTE