Nemeth et al reported the L-TRiP(cast) score for predicting venous thrombosis in a patient with cast immobilization of the lower extremity. This can help to identify a patient who may benefit from thromboprophylaxis. The authors are from Leiden University, Fondazione IRCCS Ca'Granda-Ospedale Maggiore Policlinico (Milan), and Addenbrook's Hospital (Cambridge).
L-TRiP(cast) is for Leiden Thrombosis Risk Prediction for cast immobilization
Patient selection: plaster cast immobilization of the lower extremity, from 18 to 70 years
Parameters:
(1) age of the patient in years
(2) sex
(3) current use of oral contraceptives
(4) cancer within the past 5 years
(5) pregnancy or puerperium
(6) body mass index (BMI) in kg per square meter
(7) pneumonia
(8) first-degree relatives with venous thromboembolism
(9) comorbid conditions (rheumatoid arthritis, chronic kidney disease, COPD, multiple sclerosis)
(10) hospital admission within the past 3 months
(11) bedridden within the past 3 months
(12) surgery within the past 3 months
(13) superficial venous thrombosis
(14) extent of plaster cast
|
Parameters
|
Findings
|
Points
|
|
age of the patient
|
< 35 years
|
0
|
|
|
35 to 54.99
|
2
|
|
|
>= 55 years
|
3
|
|
sex
|
male
|
1
|
|
|
female
|
0
|
|
oral contraceptives
|
no
|
0
|
|
|
yes
|
4
|
|
pregnancy/puerperium
|
no
|
0
|
|
|
yes
|
3
|
|
cancer history
|
no
|
0
|
|
|
yes
|
3
|
|
BMI
|
< 25
|
0
|
|
|
25 to 34.99
|
1
|
|
|
>= 35
|
2
|
|
pneumonia
|
no
|
0
|
|
|
yes
|
3
|
|
first-degree relative VTE
|
no
|
0
|
|
|
yes
|
2
|
|
comorbidity
|
no
|
0
|
|
|
yes
|
1
|
|
recent hospital admission
|
no
|
0
|
|
|
yes
|
2
|
|
recently bedridden
|
no
|
0
|
|
|
yes
|
2
|
|
recent surgery
|
no
|
0
|
|
|
yes
|
2
|
|
superficial vein thrombosis
|
no
|
0
|
|
|
yes
|
3
|
|
plaster cast
|
complete leg
|
5
|
|
|
circular knee (ankle free)
|
2
|
|
|
foot
|
2
|
|
|
lower leg
|
4
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 2
• maximum score: 35 (if oral contraceptive use and puerperium)
• A score >= 10 is associated with a higher risk of venous thrombosis.
Performance:
• The area under the ROC curve is 0.76.
