Zakai et al reported a model for venous thrombosis in a medical inpatient. These can help to identify a patient who should be observed more closely. The authors are from the University of Vermont.
Patient selection: medical inpatient
Parameters for Model 1:
(1) history of congestive heart failure
(2) history of an inflammatory disease
(3) history of fracture in the past 3 months
(4) history of venous thromboembolism (VTE)
(5) history of cancer in the past 12 months
(6) tachycardia
(7) respiratory dysfunction
(8) WBC count on admission in 10^9/L
(9) platelet count on admission in 10^9/L
|
Parameter
|
Finding
|
Points
|
|
history of CHF
|
no
|
0
|
|
|
yes
|
5
|
|
inflammatory disease
|
no
|
0
|
|
|
yes
|
4
|
|
fracture in past 3 months
|
no
|
0
|
|
|
yes
|
3
|
|
history of VTE
|
no
|
0
|
|
|
yes
|
2
|
|
recent history of cancer
|
no
|
0
|
|
|
yes
|
1
|
|
tachycardia
|
no
|
0
|
|
|
yes
|
2
|
|
respiratory dysfunction
|
no
|
0
|
|
|
yes
|
1
|
|
WBC count on admission
|
< 11 * 10^9
|
0
|
|
|
>= * 10^9/L
|
1
|
|
platelet count on admission
|
< 350 * 10^9/L
|
0
|
|
|
>= 350 * 10^9/L
|
1
|
where:
• The authors also reported a second model without WBC or platelet count.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The riso of deep venin thrombosis increased as the score increased.
• The cumulative risk of DVT increased with length of stay.
• The authors found no reduction in VTE risk with prophylaxis was not associated with reduced risk.
• A history of myocardial infarction, COPD, diabetes, and chronic kidney disease were associated with a reduced risk of VTE.
Performance:
• The area under the ROC curve was 0.73
