The Cardiovascular
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RIETE Score for Risk of Hemorrhage in Pulmonary Embolism Treatment

Bleeding risk during anticoagulation for acute venous thromboembolism.

RIETE Score for Risk of Hemorrhage in Pulmonary Embolism Treatment
Recent major bleeding (within prior month)
Active cancer
Creatinine >1.2 mg/dL
Anemia (Hb <13 g/dL men, <12 g/dL women)
Age >75 years
Clinically overt pulmonary embolism (rather than isolated DVT)
Result0.0 points

Estimated major bleeding risk in the first 3 months of anticoagulation: ~0.3 %.

Risk category
Low

When to use

  • Weighing bleeding risk against benefit before starting or continuing anticoagulation for acute VTE.

Formula

Points: recent major bleeding 2, cancer 1, creatinine >1.2 mg/dL 1.5, anemia 1.5, age >75 1, overt PE 1. Low risk 0, intermediate 1-4, high >4.

Pearls and pitfalls

  • Captures only baseline risk at anticoagulation initiation; does not account for interval clinical changes.

References

  1. Ruiz-Gimenez N, et al. Thromb Haemost. 2008;100(1):26-31.