Martens et al reported the HIGH-2-LOW score to predict the risk of venous thromboembolism in a patient with platelet engraftment after an allogeneic transplant. The authors are from the University of Washington Seattle, Baylor College of Medicine and University of Vermont.
HIGH-2-LOW is an acronym made from the first letters of the score parameters.
Patient selection: allogeneic hematopoietic stem cell transplant (HSCT) recipient
Platelet count recovery was defined as a platelet count > 20 * 10^9/L OR > 50 * 10^9/L without platelet transfusion for >= 7 days.
Parameters:
(1) history of catheter-related DVT (H)
(2) inpatient admission (I)
(3) GVHD (G)
(4) history of pulmonary embolism or lower extremity DVT (H)
(5) lymphoma diagnosis (L)
(6) obesity based on BMI (O)
(7) WBC count in 10^9/L (W)
|
Parameter
|
Finding
|
Points
|
|
history of catheter-related DVT
|
no
|
0
|
|
|
yes
|
1
|
|
inpatient admission
|
no
|
0
|
|
|
yes
|
1
|
|
GVHD
|
no, Grade 1 or Grade 2
|
0
|
|
|
Grade 3 or 4
|
1
|
|
history of PE or LE DVT
|
no
|
0
|
|
|
yes
|
2
|
|
lymphoma
|
no
|
0
|
|
|
yes
|
1
|
|
BMI
|
< 35 kg per sq m
|
0
|
|
|
>= 35 kg per sq m
|
1
|
|
WBC count
|
< 11 * 10^9/L
|
0
|
|
|
>= 11 * 10^9/L
|
1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A patient with a higher score may benefit from anticoagulant prophylaxis.
|
Total Score
|
VTE Risk Group
|
DVT at 100 Days
|
|
0
|
low
|
1.5%
|
|
1
|
intermediate
|
3.6%
|
|
>= 2
|
high
|
10.3%
|
Performance:
• The area under the ROC curve was 0.69.
