Use of a personalized iterative score to evaluate risk of venous thromboembolism during pregnancy and puerperium.

ABSTRACT

OBJECTIVE: To determine whether a personalized iterative venous thromboembolism (VTE) risk score improved preventive prophylaxis during pregnancy and puerperium. METHODS: An observational retrospective comparative study was conducted at single French hospital. Women who gave birth from February 1 to April 30, 2012 (n=557) or from February 1 to April 30, 2015 (n=512) underwent VTE risk assessment. The VTE risk score comprised known risk factors for this condition. RESULTS: Use of the VTE risk score at the first consultation increased the likelihood of appropriate treatment (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2-1.9; P=0.002) and reduced the risk of undertreatment (OR 0.5, 95% CI 0.4-0.7; P<0.001). During hospitalization and puerperium, the VTE risk score increased the likelihood of appropriate treatment. The ORs were 6.2 (95% CI 2.1-18.9; P<0.001) and 5.4 (95% CI 4.1-7.2; P<0.001), respectively. The risk of undertreatment was also reduced at these time points. CONCLUSION: Use of the VTE risk score increased the number of appropriately treated patients during pregnancy and puerperium.