This Riete score for risk of hemorrhage in pulmonary embolism calculator estimates the risk of major bleeding in patients treated for acute venous thromboembolism. You can read more about the criteria employed and the score risk interpretation below the form.


Recent major bleeding

Anemia present (Hb <13 g/dL male, Hb <12 g/dL female)

Creatinine > 1.2 mg/dL

Malignancy

Clinically overt PE

Age > 75

How does this Riete score for risk of hemorrhage in pulmonary embolism calculator work?

This is a risk assessment health calculator designed to estimate the risk of any kind of major bleeding in patients that undergo or are to undergo anticoagulant treatment therapy such as warfarin, for acute venous thromboembolism in PE.

This Riete score for risk of hemorrhage in pulmonary embolism calculator is an accurate way of determining the hemorrhage risk and distinguishes between three tiers of risk: low, moderate and high. The criteria evaluated are the following:

Criteria Score
Recent major bleeding 2
Anemia present (Hb <13 g/dL male, Hb <12 g/dL female) 1.5
Creatinine > 1.2 mg/dL 1.5
Malignancy 1
Clinically overt PE 1
Age > 75 1

Score interpretation for hemorrhage risk

Score Major bleeding % Risk level
0 0.1 Low
1 1.4 Moderate
1.5 - 2 2.2
2.5 - 3 4.4
3.5 - 4 4.2
4.5 - 5 4.9 High
5.5 - 6 11
> 6 20

Anticoagulation treatment AT is still one of the preferred ways of dealing with PE. However, in some case, this could be counter indicated because of other hemorrhage risk factors thus models such as Riete are used to stratify bleeding risk.

In high risk cases, anticoagulation treatment cannot be started and research has tried to come up with ways to overcome this barrier. Thrombolytic therapy is one of the solutions but there is still not enough adequate statistics to associate with improved survival by comparison to conventional anticoagulation.

Major bleeding

This is defined by hemorrhage needing transfusion of at least 2 units of red blood cells, a decline in hemoglobin concentration of at least 20g/L, intracranial, spinal or retroperitoneal bleeding. The most important signs of internal bleeding are:

- Bleeding from body openings such as mouth, nose or ear

- Vomiting blood

- Hemoptysis (coughing blood)

- Tender/ swollen stomach

- Cold, clammy skin

- Pallor

- Sweating

- Bruising

- Dehydration

- Shock, weak pulse

Reference

Ruíz-Giménez N, Suárez C, González R, Nieto JA, Todolí JA, Samperiz AL, Monreal M; RIETE Investigators. Predictive variables for major bleeding events in patients presenting with documented acute venous thromboembolism. Findings from the RIETE Registry.Thromb Haemost. 2008 Jul; 100(1): 26-31.

01 Jul, 2015