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Terms, definitions, and characterizing risk factors for indefinite anticoagulation

Terms, definitions, and characterizing risk factors for indefinite anticoagulation
Term Definition and examples
No identifiable risk factor (unprovoked) VTE where no identifiable provoking event or risk factor is evident
Identifiable risk factor (provoked) VTE caused by a known event or risk factor (eg, surgery, hospital admission, estrogen)
Transient risk factor Risk factors for VTE that are reversible
  • Major risk factors (ie, transient factors that favor limited-duration anticoagulation):
    • Major surgery >30 minutes, hospitalization or confined to bed with "bathroom privileges" for ≥3 days due to acute illness, CS, trauma with fractures, estrogen therapy, pregnancy or puerperium
  • Minor risk factors (ie, transient factors that favor continuing anticoagulation):
    • Minor surgery <30 minutes, hospitalization <3 days, reduced mobility at home ≥3 days due to acute illness, lower extremity injury without fracture with reduced mobility ≥3 days, long-haul flight
Persistent risk factor Risk factors that persist over a prolonged period of time
  • Examples include irreversible conditions such as active malignancy, obesity, active inflammatory bowel disease, active autoimmune disease, continued hormonal therapy, nephrotic syndrome, recurrent long-haul flights
Proximal DVT of lower extremity VTE that is in the popliteal, femoral, or iliac veins
Distal DVT of lower extremity VTE that is without a proximal component and confined to the calf veins (peroneal, posterior, anterior tibial, and muscular veins)
Pulmonary embolism Thrombus in the main, segmental, or subsegmental branches of the pulmonary artery
Initial anticoagulation Anticoagulant therapy that is administered immediately following a diagnosis of VTE
Anticoagulation following initial phase Anticoagulant therapy that is typically administered for a finite time period (ie, scheduled stop date, typically 3 months)
Extended anticoagulation Anticoagulant therapy that is administered beyond the typical 3 months but with a scheduled stop date (eg, 6 to 12 months)
Indefinite anticoagulation Anticoagulant therapy that is administered beyond the typical 3 months but without a scheduled stop date
DOACs Also known as newer/novel oral anticoagulants (NOAs), non-vitamin K antagonist oral anticoagulants (NOACs), and target-specific oral anticoagulants (TOACs, TSOACs)
VTE: venous thromboembolism; CS: cesarian section; DVT: deep venous thrombosis; DOACs: direct oral anticoagulants.
Graphic 131266 Version 3.0

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