The Post-Thrombotic Score (PTS) of Brandjes et al

Description

The Post-Thrombotic Syndrome (PTS) refers to the long term sequelae following a venous thrombosis. It usually takes 5 or more years to develop and may range from a mild condition to one that is incapacitating. Brandjes et al developed a scoring system to grade the severity of the condition.

NOTE:

(1) This appears limited to involvement of the lower extremity.

(2) Many of the described features are those of chronic venous disease of the lower extremity (see cardiovascular chapter).

Score for Mild-to-Moderate Disease

Subjective Criteria for Mild-to-Moderate Disease	Finding	Points
spontaneous pain in calf	present	1
	absent	0
spontaneous pain in thigh	present	1
	absent	0
pain in calf on standing/walking	present	1
	absent	0
pain in thigh on standing/walking	present	1
	absent	0
edema of foot/calf	present	1
	absent	0
"heaviness" of leg	present	1
	absent	0

Subjective Criteria for Mild-to-Moderate Disease	Finding	Points
calf circumference	increased by >= 1 cm	1
	increased by < 1 cm	0
	not increased	0
ankle circumference	increased by >= 1 cm	1
	increased by < 1 cm	0
	not increased	0
pigmentation	present	1
	absent	0
venectasia	present	1
	absent	0
newly formed varicosis	present	1
	absent	0
phlebitis	present	1
	absent	0

score for mild-to-moderate disease =

= SUM(points for subjective and objective criteria present)

Score for Severe Disease

Subjective Criteria for Severe Disease	Finding	Points
spontaneous pain AND pain on standing/walking	present	1
	absent	0
edema of calf	present	1
	absent	0
impairment in daily activities	present	1
	absent	0

Objective Criteria for Severe Disease	Finding	Points
calf circumference	increased by >= 1 cm	1
	increased by < 1 cm	0
	not increased	0
pigmentation, discoloration and venectasia	present	1
	absent	0
venous ulcer	present	4
	absent	0

score for severe disease =

= SUM(points for subjective and objective criteria present)

Interpretation:

• minimum score for both scores: 0

• maximum score for mild-to-moderate disease: 12

• maximum score for maximum disease: 9

• Severe disease is present if the score for severe disease is >= 4 on 2 consecutive 3 month followup visits.

• Mild-to-moderate disease is present if the score for mild-to-moderate disease is >=3, AND 1 objective criteria is present on 2 consecutive 3 month followup visits.

• The diagnosis of post-thrombotic syndrome was not made until the patient had been followed for 6 months in order to rule out symptoms of the initial thrombotic

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The Post-Thrombotic Score (PTS) of Brandjes et al

Description

Specialty