HERDOO2 decision rule for recurrent venous thromboembolism
Clinical decision rule to identify patients at low risk of recurrent venous thromboembolism after 5-7 months of oral anticoagulant therapy.
HERDOO2 stands for: hyperpigmentation, edema, redness, D-dimer, obesity, older age, 2 scores.
Research authors: Marc A Rodger, Susan R Kahn, Philip S Wells, David A Anderson, Isabelle Chagnon, Grégoire Le Gal, Susan Solymoss, Mark Crowther, Arnaud Perrier, Richard White, Linda Vickars, Tim Ramsay, Marisol T. Betancourt, Michael J. Kovacs
Details Formula Study characteristics Files & References
★★★
Model author
Model ID
915
Version
1.4
Revision date
2017-10-16
MeSH terms
  • Thromboembolism, Venous
  • Anticoagulant Drugs
  • Clinical Prediction Rule
  • Model type
    Linear model (Calculation)
    Status
    public
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    Formula
    No Formula defined yet
    Condition Formula

    Additional information

    In 2008, Rodger et al. proposed the HERDOO2 model, deriving data from a Canadian multicenter prospective cohort study that included 646 patients with a first unprovoked VTE event followed up for 18 months after discontinuing oralanticoagulation therapy.

    Study Population

    Total population size: 646
    Males: {{ model.numberOfMales }}
    Females: {{ model.numberOfFemales }}

    Continuous characteristics

    Name Mean SD Unit
    Age 52.5 17.5 years
    Weight 87.5 23.6 kg
    Height 171.6 10.8 cm
    BMI 29.1 7.2 kg/m2
    d-Dimer 307 403 ug/L
    Homocysteine 10.1 8.0 umol/L
    Hemoglobin 142.2 15.0 g/L
    Factor VIII 1.7 0.55 U/mL

    Categorical characteristics

    Name Subset / Group Nr. of patients
    Abnormal baseline compression ultrasound Recurrent VTE 45
    No VTE 186
    Abnormal baseline imaging Recurrent VTE 64
    No VTE 327
    Factor V Leiden Recurrent VTE 19
    no VTE 81
    VTE Recurrent 91
    No VTE 555
    V/Q scan or PVO result <95% Recurrent VTE 38
    No VTE 272
    Post-thrombotic signs HER 215
    Edema 149
    Redness 71
    Hyperpigmentation 93
    History of COPD or emphysema Recurrent VTE 1
    No VTE 39
    Family history of VTE recurrent VTE 18
    no VTE 135

    Related files

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    Supporting Publications

    HERDOO2 risk score:
    ...
    points

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    Result
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    HERDOO2 risk score: points

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    Outcome stratification

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    Conditional information

    Result interpretation

    Interpretation of results:

    • In a study by Rodger et al (2008) including 646 patients with a first unprovoked venous thromboembolism (VTE) event, an annual risk of VTE recurrence of 9.3% [95% confidence interval (CI) 7.7–11.3%) was recorded in the whole cohort, and of 13.7% in men.
    • On the basis of these results, the authors recommend a long-term anticoagulant treatment as always indicated for all men.
    • Women with a total risk score of 0 to 1 had an annual risk of recurrence of 1.6% (95% CI 0.3-4.6%), whereas those who had a score of 2 or more had an annual risk of 14.1% (95% CI 10.9–17.3%) and deserved, according to the authors, an indefinite anticoagulation.


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    Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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