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Prognostic Score for Acute Deep Vein Thrombosis (DVT) in Lower Extremity

Purpose: To evaluate an outpatient with acute deep vein thrombosis of a lower extremity using the risk score of Trujillo-Santos et al.

Description

Rosa-Salazar et al reported a prognostic score for outpatients with acute deep vein thrombosis in the lower extremity. This can help to identify a patient who may benefit from more aggressive management. The authors are RIETE (Registro Informatizado de la Enfermeded TromboEmbolica) investigators from multiple hospitals in Spain.


 

Patient selection: outpatient with acute DVT in a lower extremity

 

Outcome: pulmonary embolism, major bleeding or death within the first week

 

The same score was used by Rosa-Salazar et al for DVT of an upper extremity but with different outcome risks.

 

Parameters:

(1) chronic heart failure

(2) creatinine clearance in mL per minute

(3) history of recent major bleeding

(4) platelet count

(5) recent immobility for 4 or more days

(6) cancer

 

Parameter

Finding

Points

chronic heart failure

no

0

 

yes

1

creatinine clearance

> 60 mL/min

0

 

30 to 60 mL/min

1

 

< 30 mL/min

3

recent major bleeding

no

0

 

yes

1

platelet count

normal

0

 

abnormal (less than 100,000 or greater than 450,000 per µL(

1

recent immobility

no

0

 

yes

1

cancer

no

0

 

without metastases

1

 

with metastases

2

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 9

• A score <= 1 was considered low risk for the outcome (less than or equal to 0.6%).

 

Score

Risk of Outcome

0

0.2%

1

0.6%

2

1.7%

3

3.5%

4

4.9%

5

15%

6 to 9

30%

 


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Specialty

Objective

ICD-10