Cafferata et al used a subset of the reporting standard proposed by international consensus committee of the Society of Vascular Surgery and the North American Chapter of the International Society of Cardiovascular Surgery to report the risk of thrombosis in a patient with trauma.
Patient evaluation:
(1) initial evaluation shortly after admission (R1)
(2) evaluation at the time of discharge, death or venous thrombosis event (R2).
Risk factors:
(1) prior history of deep vein thrombosis
(2) immobilization
(3) anesthesia time (post-operative state)
(4) age
(5) cardiac disease (functional status may not be evident in a trauma patient, so was reduced to present or absent)
(6) long bone fracture (limb trauma)
(7) obesity
where:
• The age scoring was changed so that age = 70 was assigned 2 instead of 1 point.
• Quadraplegia has been added to immobilization.
• Arm fracture was added.
• The anesthesia times are changed from the original scheme.
• The other risk factors were encountered rarely and so were not included. However, pregnancy or the postpartum state would seem to be seen occasionally. Modifying the modified score to include this risk factor would be straightforward.
|
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 from paraplegia or quadraplegia |
3 |
|
anesthesia time |
none |
0 |
|
|
local or < 45 minutes |
1 |
|
|
<= 3 hours |
2 |
|
|
> 3 hours |
3 |
|
age |
< 40 years of age |
0 |
|
|
40 – 69 years |
1 |
|
|
>= 70 years |
2 |
|
cardiac disease |
none |
0 |
|
|
present |
1 |
|
long bone fracture |
none |
0 |
|
|
soft tissue injury |
1 |
|
|
fracture of tibia and/or fibula and/or arm |
2 |
|
|
fracture of the femur |
3 |
|
|
fracture of hip or pelvis |
4 |
|
obesity |
normal to 175% ideal body weight |
0 |
|
|
> 175% ideal body weight |
1 |
risk score =
= SUM(grades for all 7 factors)
Interpretation:
• minimum score: 0
• maximum score: 17 (the paper says 15)
• The higher the score, the greater the risk of deep vein thrombosis.
|
Risk Score |
Thrombosis Risk (Arbitrary) |
|
0 to 2 |
low |
|
3 to 5 |
moderate |
|
>= 6 |
high |
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
