Risk Assessment Scorecard of Lutz et al for Venous Thromboembolism

 

Parameters used in scorecard:

(1) basic comorbid risk factors

(2) acute disease risk factors

 

Scorecard: 4 x 4 grade show low, intermediate and high risk zones

 

Basic comorbid risk factors, Grade 1:

(1) dehydration

(2) polycythemia and/or thrombocytosis

(3) major varicosities

(4) history of venous thromboembolism in a family member

(5) hormone replacement therapy

(6) obesity

 

Basic comorbid risk factors, Grade 2:

(1) age > 65 years

(2) pregnancy

(3) oral contraceptive therapy

(4) nephrotic syndrome

(5) myeloproliferative syndrome

(6) 2 or more Grade 1 basic risk factors

 

Basic comorbid risk factors, Grade 3:

(1) thrombophilia

(2) personal history of venous thromboembolism

(3) metastatic malignancy

(4) 3 or more Grade 1 basic risk factors

(5) 2 or more Grade 2 basic risk factors

 

Acute risk factors, Grade 1:

(1) infection or acute inflammatory disease without immobilization

(2) infusion of venotoxic solutions via central venous catheter or port catheter

 

Acute risk factors, Grade 2:

(1) myocardial infarction

(2) NYHA Class III or IV heart failure

(3) sepsis

(4) acute decompensated COPD without mechanical ventilation

(5) infection or acute inflammatory disease with virtually complete immobilization

 

Acute risk factors, Grade 3:

(1) ischemic stroke with paralysis

(2) acute decompensated COPD with mechanical ventilation

 

Basic Comorbid	Acute Risk	Risk Group
0	0	low
1 Grade 1	0	low
1 Grade 2	0	low
1 Grade 3	0	intermediate
0	1 Grade 1	low
1 Grade 1	1 Grade 1	low
1 Grade 2	1 Grade 1	intermediate
other	other	high

 

where:

• The score card does not tally the number of acute risk factors as is done with the basic ones, but it makes sense that the risk would go up if more than 1 is present.