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01-08-2010 | Cardiology | Article

Thrombosis score card aids VTE risk assessment

Abstract

Free abstract

MedWire News: French researchers have developed an "easy-to-use" score card to help clinicians assess the risk for venous thromboembolism (VTE) in pregnant women.

Management of pregnant women at risk for VTE remains complex and guidelines do not definitively recommend optimal strategies due to limited trial data, explain Celine Chauleur (Hospital of Saint-Etienne, Saint Priest en Jarez, France) and colleagues.

"Thus, there is a real need for an easy-to-use risk score supporting which anti-thrombotic prophylaxis treatment to recommend at the beginning of pregnancy," say the researchers.

In the absence of hard evidence supporting clear treatment decisions, multiple expert opinions can be used to make therapeutic recommendations. In the present study, Chauleur and team used the Delphi method to consolidate the opinions of 19 French experts on pregnancy-related VTE.

The researchers explain that the Delphi method is a tool for building a risk assessment score supporting anti-thrombotic prophylaxis treatment options for pregnant women. It allows the inclusion of a large number of individuals from diverse locations and specialties and avoids the situation where a specific expert might dominate the consensus.

The team of experts defined treatments for pregnant women based on 32 isolated risk factors and 60 risk factor combinations, giving a database of 92 elements.

A scoring system for VTE risk in pregnant women was then developed, each score being associated with a specific treatment. Treatments considered were graduated elastic compression stockings, aspirin, prophylactic low-molecular-weight heparin (LMWH, variable durations), or adjusted-dose of LMWH throughout pregnancy and during the postpartum period.

Writing in the journal Thrombosis Research, Chauleur and co-authors conclude: "Our simple consensual scoring system offers an individual estimation of thrombosis risk during pregnancy together with its related therapeutic strategy, in accordance with most of the new international recommendations."

They add: "The accuracy of our individual risk score-based therapeutic guidance is currently being prospectively evaluated in a multicenter trial."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Laura Dean

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