癌相关性静脉血栓栓塞（Ca-VTE）治疗中的抗凝治疗存在出血并发症，并且关于其风险因素的数据有限。目前的模型无法提供准确的出血风险预测。本研究使用了英国临床实践研究数据连锁（2008-2020）生成了一组首次接受抗凝治疗的Ca-VTE患者队列。在观察期内，观察了患者180天，包括主要出血和需要住院治疗的临床相关非重大出血（CRNMB-H）。根据亚分发生危险比开发了评分方案，并根据交叉验证估计其辨识度（由C统计量表示）。共纳入了15749例接受Ca-VTE抗凝治疗的患者。经鉴定审核后，在4914人年观察期内，共鉴定出537例重大出血事件，其中包括161例主要出血和376例CRNMB-H。主要出血和CRNMB-H的发生率分别为每100人年3.3例和7.7例。独立影响出血的预测因子有膀胱癌、中枢神经系统癌症、子宫颈癌、肾癌、黑色素瘤、前列腺癌和上消化道癌。对于重大出血，总体C统计量为0.70，而对于CRNMB-H，C统计量分别为0.76和0.67。该风险评分可以识别出有重大出血风险的患者，并帮助确定治疗持续时间。版权所有。

Cancer associated venous thromboembolism (Ca-VTE) treatment with anticoagulation is associated with bleeding complications and there are limited data on risk factors. Current models do not provide accurate bleeding risk prediction.UK Clinical Practice Research Datalink data (2008-2020) was used to generate a cohort of patients with anticoagulant initiation for first Ca-VTE. Patients were observed up to 180 days for significant bleeding including major bleeding, and clinically relevant non-major bleeding requiring hospitalisation (CRNMB-H). A scoring scheme was developed from subdistribution hazard ratios, and its discrimination (expressed by the C-statistic) estimated from cross-validation.15,749 patients with Ca-VTE and anticoagulant treatment were included. In total, 537 significant bleeding events, 161 major bleeds and 376 CRNMB-H were identified after adjudicated review in 4914 person-years of observation. Incidence rates of 3.3 and 7.7 per 100 person-years were noted for major bleeding and CRNMB-H. Independent predictors of significant bleeding were cancer of the bladder, central nervous system, cervix, kidney, melanoma, prostate and upper gastrointestinal tract. Overall C-statistic for significant bleeding was 0.70, and 0.76 and 0.67 for major bleeding and for CRNMB-H, respectively.This risk score may identify patients at risk of significant bleeding, while also helping to determine treatment duration.Thieme. All rights reserved.