Sermsathanasawadi et al developed a simple score for evaluating a patient with suspected deep vein thrombosis (DVT). The authors are form Siriraj Hospital and Mahidol University in Bangkok, Thailand.
Patient selection: clinically suspected DVT, > 18 years of age
Parameters:
(1) unilateral limb pain (presuming unilateral disease)
(2) confinement to bed in days
(3) calf circumference difference in centimeters (presuming unilateral disease)
(4) previous history of venous thromboembolism
calf circumference difference =
= (circumference of affected calf) - (circumference of unaffected calf)
|
Parameter
|
Finding
|
Points
|
|
unilateral limb pain
|
no
|
0
|
|
|
yes
|
1
|
|
confinement to bed
|
no or <= 3 days
|
0
|
|
|
> 3 days
|
1
|
|
calf circumference difference
|
<= 3 cm
|
0
|
|
|
> 3 cm
|
1
|
|
history VTE
|
no
|
0
|
|
|
yes
|
1
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 2 indicates a high probability of deep vein thrombosis (DVT).
• A score <= 1 indicates a low probability of deep vein thrombosis.
A D-dimer was test was performed on all patients.
A compression ultrasound study was performed if the D-dimer test was positive or if the probability of DVT is high. It is repeated in 1 week if the test is negative in the setting of high probability and positive D-dimer.
A patient with a positive compression ultrasound is treated for deep vein thrombosis.
Performance:
• The area under the ROC curve for all patients was 0.79.
