Patient selection: hospitalized patient
Scoring for age:
|
Age
|
Points
|
|
< 41 years of age
|
0
|
|
41 to 60 years
|
1
|
|
61 to 74 years
|
2
|
|
>= 75 years of age
|
3
|
Findings scored 1 point
(2) body mass index > 25 kg per square meter (obesity
(3) acute myocardial infarction (AMI)
(4) heart failure
(5) varicose veins
(6) inflammatory bowel disease
(7) sepsis in past month
(8) COPD or abnormal pulmonary function tests
(9) severe lung disease in past month, including lung disease
(10) oral contraceptive or hormone replacement therapy
(11) pregnant or delivery in past month
(12) history of unexpected stillbirth, recurrent spontaneous abortion, premature infant with toxemia, growth-restricted infant
(13) medical patient on bedrest
(14) minor surgery
(15) history of major surgery in past month
(16) swollen legs present
Findings scored 2 points if present:
(17) central venous access
(18) arthroscopic surgery
(19) major surgery (any procedure lasting > 45 minutes)
(20) malignancy (current or previous)
(21) laparoscopic procedure lasting > 45 minutes
(22) patient confined to bed > 3 days (> 72 hours)
(23) immobilizing plaster cast during past month
Findings scored 3 points if present:
(24) history of deep vein thrombosis or pulmonary embolism
(25) thrombophilic gene mutation (Factor V Leiden, prothrombin G20210A, elevated serum homocysteine)
(26) positive lupus anticoagulant
(27) heparin-induced thrombocytopenia
(28) family history of venous thromboembolism
(29) elevated cardiolipin antibodies
Findings scored 5 points if present:
(30) stroke in past month
(31) multiple trauma in past month
(32) elective major lower extremity arthroplasty (knee or joint replacement, etc)
(33) hip, pelvis or leg fracture
(34) acute spinal cord injury with paralysis in past month
total risk score =
= SUM(points for all 34 items)
Interpretation:
• minimum score: 0
• maximum score: 73
• The higher the score the greater the risk for thromboembolism.
|
Score
|
Risk
|
|
0 or 1
|
low
|
|
2
|
moderate
|
|
3 or 4
|
high
|
|
>= 5
|
very high
|
