MDCalc

DASH Prediction Score for Recurrent VTE

Predicts likelihood of recurrence of first VTE.

Do NOT use in patients with active hemorrhage or signs/symptoms of VTE.

D-dimer abnormal
Measured ~1 month after stopping anticoagulation
Age ≤50 years
Male patient
Hormone use at VTE onset (if female)
If male patient, select "No"

Result:

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Management

In a patient with previously diagnosed VTE who has completed a 3-6 month course of anticoagulation:

  • DASH ≤1:
    • Consider discontinuing anticoagulation, as this group has an annual recurrence risk of 3.1%.
  • DASH ≥2:
    • Consider continuing anticoagulation, as this group has an annual recurrence risk of 9.3%.
Critical Actions
  • No decision rule should trump clinical gestalt. Consider the clinical scenario before continuing or discontinuing anticoagulation for VTE.
  • The DASH Score is meant to be applied to stable patients. It should not be applied to patients with active hemorrhage or those with signs and symptoms of VTE.
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