目前的临床指南建议对诊断为急性深静脉血栓 (DVT) 的患者进行家庭治疗。已提出预后评分来识别低风险患者；然而，其验证仍然有限。这项前瞻性观察性研究旨在从外部验证选择低风险下肢急性 DVT 门诊患者的预后评分。纳入三级医院连续门诊诊断为急性 DVT 的患者。评分包括 6 个变量：心力衰竭、肾衰竭、近期大出血、血小板计数改变、制动和癌症。主要结局是复合结局的发生率，包括确诊为 PE、大出血或 7 天时全因死亡。符合零标准的患者被认为是低风险。在纳入的 1035 名患者中，485 名 (46.9%) 符合零标准。其中，分别有 0.2% (95% CI 0.0-1.1%) 和 0.4% (95% CI, 0.0-1.5%) 患者在第 7 天和第 30 天出现复合结果。在满足一项或多项入院标准的患者中，344 名患者（62.5%）出院。其中，第 7 天和第 30 天的复合结果分别发生在 2 名 (0.6%) 和 5 名 (1.4%) 患者中。第 7 天和第 30 天时评分的 C 统计量分别为 0.68（95% CI，0.57-0.79）和 0.69（95% CI，0.64-0.76）。本研究证明了预后评分在识别低预后方面的有效性。门诊患者患有急性 DVT 的风险。它还表明，尽管有一些风险标准，但相当一部分急性 DVT 患者可能会从门诊治疗中受益，这凸显了优化门诊护理途径的潜力。版权所有 © 2024。由 Elsevier B.V. 出版。

Current clinical guidelines suggest home treatment for patients diagnosed with acute deep venous thrombosis (DVT). A prognostic score has been proposed to identify low-risk patients; however, its validation remains limited.This prospective observational study aimed to externally validate the prognostic score in selecting low-risk outpatients with acute DVT in the lower limbs. Consecutive outpatients diagnosed with acute DVT in a tertiary hospital were included. The score included 6 variables: heart failure, kidney failure, recent major bleeding, altered platelet count, immobilization, and cancer. The primary outcome was the incidence of a composite outcome, including confirmed diagnosis of PE, major bleeding, or all-cause death at 7 days. Patients meeting zero criteria were considered low risk.Among the 1035 patients included, 485 (46.9 %) met zero criteria. Of these, 0.2 % (95 % CI 0.0-1.1 %) and 0.4 % (95 % CI, 0.0-1.5 %) patients experienced the composite outcome at 7 and 30 days, respectively. Among patients who met 1 or more criteria for admission, 344 patients (62.5 %) were discharged. Among these, the composite outcome at 7 and 30 days occurred in 2 (0.6 %) and 5 (1.4 %) patients, respectively. The C-statistics of the score were 0.68 (95 % CI, 0.57-0.79) and 0.69 (95 % CI, 0.64-0.76) at 7 and 30 days, respectively.This study demonstrates the efficacy of the prognostic score in identifying low-risk outpatients with acute DVT. It also suggests that a considerable proportion of patients with acute DVT may benefit from outpatient treatment despite having some risk criteria, highlighting the potential for optimizing ambulatory care pathways.Copyright © 2024. Published by Elsevier B.V.