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HERDOO2 rule for discontinuing anticoagulation in unprovoked VTE
Identifies women with unprovoked VTE who may safely stop anticoagulation.
HERDOO2 rule for discontinuing anticoagulation in unprovoked VTE
Post-thrombotic signs: hyperpigmentation, oedema, or redness in either leg
D-dimer >=250 ug/L (while on anticoagulation)
BMI >=30 kg/m2
Age >=65 years
Result0 points
Low risk: recurrence risk is low enough that stopping anticoagulation after short-term therapy is reasonable.
- Recommendation
- May discontinue
When to use
- Deciding whether a woman with a first unprovoked VTE can stop anticoagulation after completing initial treatment.
Formula
One point each: leg signs (Hyperpigmentation/Edema/Redness), D-dimer >=250 ug/L, Obesity (BMI>=30), Older (age>=65). Score 0-1 = low risk; >=2 = high risk.
Pearls and pitfalls
- Derived and validated only in women; men have a higher recurrence rate and are treated as high risk.
- Does not apply after a provoked VTE or with an ongoing major risk factor.