Caprini et al reported a worksheet for identifying risk factors associated with venous thromboemboli in a surgical patients. The authors are from Glenbrook Hospital (Greenview) and Northwestern University.
Patient selection: surgical patient
Parameters:
(1) age in years
(2) history of deep vein thrombosis (DVT) or pulmonary embolism (PE)
(3) varicose veins
(4) anticipated bed confinement in hours
(5) history of previous major immobilization
(6) previous immobilization
(7) acute myocardial infarction
(8) congestive heart failure
(9) stroke
(10) crystalloid infusion in liters per hour
(11) COPD
(12) trauma
(13) duration of planned operation in hours
(13) type of surgery
(14) confining travel within one week of admission
(15) history of pelvic or long bone fracture
(16) leg edema, ulcers or stasis
(17) malignancy (including polycythemia vera)
(18) pregnancy or postpartum within past month
(19) inflammatory bowel disease
(20) severe infection (including sepsis)
(21) hormone therapy
(22) hypercoagulable state (congenital or acquired; protein S or C deficiency, plasminogen disorder, nephrotic syndrome, PNH, lupus anticoagulant)
(23) obesity (> 20% over ideal body weight)
(24) history of previous major surgery
(25) other
|
Parameter |
Finding |
Points |
|
age in years |
<= 40 years |
0 |
|
|
41 to 60 years |
1 |
|
|
61 to 70 years |
2 |
|
|
> 70 years |
3 |
|
history of DVT or PE |
no |
0 |
|
|
yes |
3 |
|
varicose veins |
no |
0 |
|
|
yes |
1 |
|
anticipated confinement in bed |
<= 72 hours |
0 |
|
|
> 72 hours |
1 |
|
history of previous major immobilization |
no |
0 |
|
|
yes |
1 |
|
previous immobilization |
<= 72 hours |
0 |
|
|
> 72 hours |
1 |
|
acute myocardial infarction |
no |
0 |
|
|
yes |
1 |
|
congestive heart failure |
no |
0 |
|
|
yes |
1 |
|
stroke |
no |
0 |
|
|
yes |
1 |
|
crystalloid infusion |
<= 5 liters in 24 hours |
0 |
|
|
> 5 hours in 24 hours |
1 |
|
COPD |
none, mild or moderate |
0 |
|
|
severe |
1 |
|
trauma |
no |
0 |
|
|
yes |
1 |
|
duration of planned surgery |
<= 2 hours |
0 |
|
|
> 2 hours |
1 |
|
type of surgery |
pelvic or total joint replacement |
1 |
|
|
other |
0 |
|
confining travel |
<= 4hours |
0 |
|
|
> 4 hours |
1 |
|
history of pelvic long bone fracture |
no |
0 |
|
|
yes |
1 |
|
leg edema, ulcers or stasis |
no |
0 |
|
|
yes |
1 |
|
malignancy |
no |
0 |
|
|
yes |
1 |
|
pregnant or recent postpartum |
no |
0 |
|
|
yes |
1 |
|
inflammatory bowel disease |
no |
0 |
|
|
yes |
1 |
|
severe infection |
no |
0 |
|
|
yes |
1 |
|
hormone therapy |
no |
0 |
|
|
yes |
1 |
|
hypercoagulable state |
no |
0 |
|
|
yes |
1 |
|
obesity |
no |
0 |
|
|
yes |
1 |
|
history of previous major surgery |
no |
0 |
|
|
yes |
1 |
|
other risk factor |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all of the parameters present)
Interpretation:
• minimum score: 0
• maximum score: 30
|
Total Score |
Risk of Thromboembolism |
|
0 |
? very low risk |
|
1 |
low risk |
|
2 to 4 |
moderate risk |
|
>= 5 |
high risk |
Specialty: Hematology Oncology
