Risk Assessment for Thrombosis

Age (years)

41–60

1

60–74

2

≥ 75

3

Surgery

Minor surgery during current hospitalization

1

Major surgery within the past 1 month

1

Arthroscopic surgery during current hospitalization

2

Major surgery lasting > 45 minutes during current hospitalization

1

Laparoscopic surgery lasting > 45 minutes during current hospitalization

2

Elective major arthroplasty of the leg during current hospitalization

5

Coexisting conditions

Varicose veins

1

Inflammatory bowel disease

1

Edema, leg (current)

1

Obesity (BMI > 25)

1

Acute myocardial infarction

1

Heart failure within the preceding 1 month

1

Sepsis within the preceding 1 month

1

Serious lung disease* within the preceding 1 month

1

Abnormal pulmonary function (eg, COPD)

1

Central venous access

2

Cancer (present or previous)

2

History of DVT/PE

3

Family history of thrombosis†

3

Factor V Leiden mutation

3

Prothrombin 20210A mutation

3

Elevated serum homocysteine

3

Positive lupus anticoagulant

3

Elevated anticardiolipin antibodies

3

Heparin-induced thrombocytopenia

3

Other congenital or acquired thrombophilia

3

Stroke within the preceding 1 month

5

Multiple trauma within the preceding 1 month

5

Acute spinal cord injury/paralysis within the preceding 1 month

5

Immobilization

Current bed rest (medical patient)

1

Bed rest > 72 hours

2

Immobilizing plaster cast within the preceding 1 month

2

Hip, pelvis, or leg fracture within the preceding 1 month

5

Additional risk factors for women

Oral contraceptive use or hormone replacement therapy

1

Pregnancy or postpartum within the preceding 1 month

1

History of unexplained stillbirth, recurrent spontaneous abortion (≥ 3), premature birth with toxemia or growth-restricted infant

1

Other

Other risk factors‡

1