Pomero et al developed a clinical score for identifying a patient with superficial vein thrombosis who has a concurrent deep vein thrombosis. The authors are from Croce e Carle, Federico II University, Insubria University, University of Palermo, University of Udine and IRCCS Milan in Italy.
Patient selection: superficial vein thrombosis (SVT)
ICARO stands for idiopathic, cancer, age, rope-like sign, and oedema.
Parameters:
(1) history of cancer
(2) edema of the affected limb
(3) rope-like sign
(4) age in years
(5) idiopathic (unprovoked) superficial vein thrombosis (SVT). This requires exclusion of malignancy, recent surgery, recent trauma, infection, immobilization, hormonal therapy, obesity, cardiac failure, respiratory failure or varicose veins.
|
Parameter
|
Finding
|
Points
|
|
history of cancer
|
no
|
0
|
|
|
yes
|
1.5
|
|
edema of affected limb
|
no
|
0
|
|
|
yes
|
1.5
|
|
rope-like sign
|
absent
|
0
|
|
|
present
|
-1
|
|
age in years
|
<= 50 years of age
|
0
|
|
|
> 50 years of age
|
1
|
|
idiopathic SVT
|
no
|
0
|
|
|
yes
|
-1
|
where:
• A history of cancer precludes idiopathic SVT.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: -2
• maximum score: 4
• The higher the score the greater the chances of concomitant deep vein thrombosis.
|
Total Score
|
Risk of Concomitant DVT
|
|
-2 to 0
|
low
|
|
0.5 or 1
|
intermediate
|
|
>= 1.5
|
high
|
Performance:
• The area under the ROC curve is 0.77.
