Deep Vein Thrombosis: Lower Extremity (Venous Thromboembolism/VTE)

Abstract

I80.2

Appendices

Appendix A

Caprini Risk Assessment Model

(Wells PS, Anderson DR, Roger M, Forgie M, Kearon C, Dreyer J, Kovacs G, Mitchell M, Lewandowski B, Kovacsb MJ. N Engl J Med 2003;349:1227–1235)

• DVT unlikely: 0–1

• DVT likely: 2/greater

1 Point

• Acute Myocardial Infarction

• Age 41–60 year

• BMI >25 kg/m2

• COPD

• Heart Failure

• Hx major surg (<1 month)

• Lung dis (serious)

• Medical pt on bed rest

• Minor surg

• Sepsis (<1 month)

• Swollen legs

• Varicose veins

2 Points

• Age 61–74 years

• Arthroscopic surg

• Cancer (past/present)

• Central venous access

• Immobilizing plaster cast

• Laparoscopic surg

• Major open surg

3 Points

• Age

• Elev serum homocysteine

• FH VTE

• Heparin-induced thrombocytopenia

• Hx VTE

• Pos Factor V Leiden

• Pos lupus anticoagulant

• Pos prothrombin 20210A

• Other cong/acq thrombophilia

4 Points

• Acute spinal cord injury (<1 month)

• Elective arthroplasty

• Fracture

• Hip

• Leg

• Pelvis

• Multiple trauma (<1 month)

• Stroke (<1 month)

Appendix B

Primary Care Rule

(Toll DB, Oudega R, Vergouwe Y, Moons KG. Fam Pract 2008;25:3–8)

• Very low risk: 0–3

• Increased risk: 4/greater

• Absence of leg trauma 1

• Active cancer past 6 months 1

• Collateral leg vein distention 1

• Male gender 1

• Surgery prev mo 1

• Use hormone contraceptive 1

• Calf circumference difference

• >2 cm²

• Abnormal D-dimer assay 6