For healthcare professionals
VTE-BLEED score calculator
The VTE-BLEED score adds points for six factors linked to major bleeding in people who take a blood thinner for venous thromboembolism (VTE), a deep vein thrombosis or pulmonary embolism. This tool is written for clinicians and is not a diagnosis.
Patient details
For people on anticoagulation for a DVT or pulmonary embolism. Nothing you enter leaves this page.
What you will see
The total VTE-BLEED score from 0 to 9, its risk group and the points for each factor.
Educational only, not medical advice. Never start, stop or skip a blood thinner on your own.
Source
The VTE-BLEED score by Klok FA and colleagues, European Respiratory Journal 2016 (cited, not quoted), with the items, points and risk groups as printed in the open access Table 1 of Lecumberri and colleagues, TH Open 2021 (CC BY). The major bleeding shares by group are from Table 3 of the same paper. The tests check each item, the men-only hypertension item, the maximum of 9, the cut-off of 2 and the age 60 edge.
Validated in
Lecumberri and colleagues note that the score was derived to assess bleeding risk in patients under stable anticoagulation, at least 1 month after the VTE. They tested it in 82,239 patients with acute VTE in the RIETE registry, an international registry of people treated for VTE.
Limits
Only for people on anticoagulation for VTE. It counts bleeding risk factors; it does not estimate the risk of a new clot or decide how long treatment should last. In the RIETE registry 62.3% of patients were in the high group, the AUC was 0.69 to 0.72 across the time periods, and the positive predictive value was low (0.6 to 3.9%), as printed by Lecumberri and colleagues. The bleeding shares come from the RIETE registry (Lecumberri and colleagues), not from the derivation study, and are group averages, not a personal prediction. The renal item is printed in the open table as eGFR under 60 mL/min, and uncontrolled hypertension was defined in that study as systolic blood pressure over 140 mmHg at baseline; the original definitions are in Klok and colleagues 2016. Age 60 counts (60 or older); age 59 does not.
The point table
VTE-BLEED score, as printed in Lecumberri and colleagues 2021, Table 1 (Lecumberri 2021) (Klok 2016):
- Active cancer: 2
- Male with uncontrolled arterial hypertension: 1
- Anemia (hemoglobin under 13 g/dL in men, under 12 g/dL in women): 1.5
- History of bleeding: 1.5
- Age 60 or older: 1.5
- Renal dysfunction (eGFR under 60 mL/min): 1.5
The maximum is 9 in men and 8 in women, because the hypertension item scores only in men. Scores go up in steps of 0.5.
Worked example: a 72-year-old woman (1.5) with anemia (1.5), no cancer, no past bleeding and normal kidney function, scores 3, the high group.
Risk groups
Lecumberri and colleagues print two groups: low risk under 2 points and high risk 2 or more points (Lecumberri 2021). Age 60 or older alone (1.5) stays low, but any second item, or active cancer alone, reaches the high group. In the RIETE registry, as reported by Lecumberri and colleagues (a validation study, not the derivation by Klok and colleagues), the share of patients with major bleeding was (Lecumberri 2021):
- Days 1 to 30: low 0.5%, high 2.0%
- Days 31 to 90 (patients still on treatment after 30 days): low 0.2%, high 0.8%
- Days 91 to 180 (on treatment after 90 days): low 0.1%, high 0.6%
- Days 181 to 360 (on treatment after 180 days): low 0.2%, high 0.6%
Reading the result
Lecumberri and colleagues found that VTE-BLEED and the RIETE score performed similarly across the four periods, with AUCs of 0.69 to 0.72, and that both had low positive predictive values, better for early bleeding than later (Lecumberri 2021). Because most patients in the registry (62.3%) were in the high group, a high score flags many people who will not bleed; a low score is more reassuring (negative predictive value 99.5% or higher in every period). The authors also note that VTE-BLEED was designed for patients under stable anticoagulation, at least 1 month after the clot, so it is less suited to the first weeks of treatment (Lecumberri 2021).
General safety advice (not part of the score): a bleeding score is one input in the choice about how long to treat, alongside the risk of a new clot. Never stop, skip or change a blood thinner because of a score. Talk to the clinician who prescribes it.
Related tools
For the risk of a new clot after a first unprovoked VTE, see the DASH score. For bleeding risk with atrial fibrillation, see the HAS-BLED score, the ORBIT bleeding score and the ATRIA bleeding score. To estimate kidney function first, use the eGFR calculator. Other bedside scores are listed under For healthcare professionals.
Sources
- Lecumberri R, Jiménez L, Ruiz-Artacho P, Nieto JA, Ruiz-Giménez N, Visonà A, Skride A, Moustafa F, Trujillo J, Monreal M, RIETE investigators. Prediction of major bleeding in anticoagulated patients for venous thromboembolism: comparison of the RIETE and the VTE-BLEED scores. TH Open. 2021;5(3):e319-e328. doi:10.1055/s-0041-1729171. PMID 34568742. Open access (CC BY). Table 1 (VTE-BLEED items, points and risk categories) and Table 3 (major bleeding by risk category and period). pmc.ncbi.nlm.nih.gov/articles/PMC8459175/
- Klok FA, Hösel V, Clemens A, Yollo WD, Tilke C, Schulman S, Lankeit M, Konstantinides SV. Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment. Eur Respir J. 2016;48(5):1369-1376. doi:10.1183/13993003.00280-2016. PMID 27471209. Cited, not quoted. doi.org/10.1183/13993003.00280-2016
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.