Table 3 Different models to assess venous thromboembolism events risk
From: Preventive strategies for hypercoagulation in Cushing’s syndrome: when and how
Score | When to use | Variable – point(s) | Interpretation |
|---|---|---|---|
Modified Caprini VTE Risk Assessment32 | Patients undergoing non-orthopedic surgery | Age – 1 to 3 Type of surgery – 1, 2 or 5 Medical history – 1,2,3 or 5 Physical signs – 1 Other risk factors – 1 | 0 (very low risk) – no thromboprophylaxis |
1–2 (low risk) – mechanical prophylaxis* | |||
3–4 (moderate risk) – LMWH + mechanical prophylaxis | |||
≥ 5 (high risk) – LMWH + mechanical prophylaxis | |||
Geneva Risk Score33 | Hospitalized medical patients | Diseases with increased VTE risk – 2 (each) Known hypercoagulable state – 2 Immobilization for ≥ 3 days – 1 Recent travel for > 6 h – 1 Age > 60 years – 1 Obesity – 1 Chronic venous insufficiency – 1 Pregnancy – 1 HT – 1 Dehydration – 1 | < 3 (low risk) – no VTE prophylaxis indicated |
≥ 3 (high risk) – VTE prophylaxis indicated | |||
Padua Prediction Score34 | Hospitalized patients | Active cancer – 3 Previous VTE – 3 Reduced mobility – 3 Known thrombophilic condition – 3 Recent trauma/surgery – 2 ≥ 70 years – 1 Heart/Respiratory failure – 1 Acute MI/ischemic stroke – 1 Acute infection/rheumatologic disorder – 1 Obesity – 1 Ongoing HT – 1 | < 4 (low risk) – pharmacologic prophylaxis is NOT indicated. Consider using mechanical prophylaxis |
≥ 4 (high risk) – pharmacologic prophylaxis is indicated. If high risk of bleeding, use mechanical prophylaxis | |||
IMPROVEDD Risk Score35 | Hospitalized patients | Previous VTE – 3 Known thrombophilia – 2 Lower-limb paralysis – 2 Current cancer – 2 Immobilized ≥ 7 days – 1 ICU/CCU stay – 1 Age > 60 years – 1 D-dimer ≥ 2xULN – 2 | Calculates the 42 and 77-day VTE risk, but doesn´t make any recommendation regarding the need of VTE prophylaxis |
CS-VTE Score36 | Patients with active CS | Age ≥ 69 years – 2 Reduced mobility – 2 Acute severe infection – 1 Previous CV events – 1 Midnight plasma cortisol > 3.15xULN – 1 Shortened APTT – 1 | Stratify the VTE risk (2 points - low risk, 3 points - moderate risk, 4 points -high risk, and ≥ 5 points - very high risk), but doesn’t make any recommendation regarding the need of VTE prophylaxis |