An international consensus committee of the Society of Vascular Surgery and the North American Chapter of the International Society of Cardiovascular Surgery updated the reporting standards for venous disease formulated in 1988.
Risk factors:
(1) prior history of deep vein thrombosis
(2) immobilization
(3) post-operative state
(4) age
(5) malignancy
(6) tissue type of malignancy
(7) cardiac disease
(8) limb trauma
(9) prethrombotic state
(10) hormonal therapy with prolonged exogenous ethinyl estradiol in a dosage > 50 µg per day
(11) pregnancy and post-partum state
(12) obesity
|
Risk Factor |
Finding |
Grade |
|---|---|---|
|
prior history of DVT |
none |
0 |
|
|
suspected |
1 |
|
|
proven |
2 |
|
|
multiple |
3 |
|
immobilization |
none |
0 |
|
|
1 – 3 days |
1 |
|
|
> 3 days |
2 |
|
|
immobilization caused by acute paraplegia |
3 |
|
post-operative state |
local anesthesia |
0 |
|
|
regional or general, < 45 minutes |
1 |
|
|
regional or general, >= 45 minutes |
2 |
|
|
extensive major (> 3 hours) and/or pelvic operation |
3 |
|
age |
< 40 years of age |
0 |
|
|
40 – 70 years |
1 |
|
|
> 70 years |
2 |
|
malignancy |
none |
0 |
|
|
nonrecurrence or local recurrence only |
1 |
|
|
extensive regional tumor |
2 |
|
|
metastatic |
3 |
|
tissue type of malignancy |
other than adenocarcinoma |
0 |
|
|
adenocarcinoma, especially mucinous |
1 |
|
|
malignant glioma of the brain |
1 |
|
cardiac disease |
none |
0 |
|
|
NYHA class 1 |
0 |
|
|
NYHA class 2 |
1 |
|
|
NYHA class 3 |
2 |
|
|
NYHA class 4 |
3 |
|
limb trauma |
none |
0 |
|
|
soft tissue injury |
1 |
|
|
fracture of tibia and/or fibula |
2 |
|
|
fracture of the femur |
3 |
|
|
fracture of hip or pelvis |
4 |
|
prethrombotic state |
none suspected |
0 |
|
|
suspected |
1 |
|
|
proven, treated |
2 |
|
|
proven, untreated |
3 |
|
hormonal therapy |
no |
0 |
|
|
yes |
1 |
|
pregnancy and postpartum state |
absent |
0 |
|
|
present |
1 |
|
obesity |
normal to 175% ideal body weight |
0 |
|
|
> 175% ideal body weight |
1 |
risk score =
= SUM(grades for all 12 factors)
Interpretation:
• minimum score: 0
• maximum score: 28
• The higher the score, the greater the risk of deep vein thrombosis.
Limitations:
• I am not sure that the increased risk for thrombosis is accurately reflected by the point assignment. For example, a person with proven prethrombotic state that is untreated would have a much higher risk than a person for whom it is only suspected. Assigning points in the range 0-4 constrains the true risk.
Purpose: To evaluate a patient's risk for deep vein thrombosis using the score of the International Consensus Committee on Chronic Venous Disease.
Specialty: Hematology Oncology, Clinical Laboratory
Objective: risk factors
ICD-10: I80,
