The DASH score, or the "D-dimer, Age, Sex, Hormonal therapy" score, is a clinical calculator used to predict the risk of recurrent Venous Thromboembolism (VTE) in patients who have had a first unprovoked VTE. This scoring system is particularly useful in guiding clinicians on whether to continue or discontinue anticoagulation therapy in these patients.
The DASH score takes into account four factors: D-dimer levels two months after stopping anticoagulation (2 points if positive), patient's age (1 point if less than 50 years old), sex (1 point if female), and hormonal therapy use at the time of the event (1 point if yes).
Patients with a DASH score of 0 or 1 have a low risk of VTE recurrence and may be considered for discontinuation of anticoagulation, while those with a score of 2 or more have a higher risk and may benefit from continued anticoagulation.
The DASH score should not be used in patients with provoked VTE, as it was not designed or validated for this population. It also may not be applicable in patients with cancer-associated VTE.
Reference
A Tosetto, A Iorio, M Marcucci et al. Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: a proposed prediction score (DASH). J Thromb Haemost. 2012 Jun;10(6):1019-25.
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