Apparently this educational endeavor is defunct because I cannot find a word about it in my Google searching. "SCORE IT" DVT Patient Profiler for Selected Patients at Risk was presented by CARE FORCE (Clot Assessment & Risk Reduction Through Education). The acronym SCORE IT cues the nurse to remember what patient types are at greater risk. The more catagories that apply to a specific patient, the greater the risk and the need for higher levels of DVT prevention protocols in the hospital to be implemented in order to prevent a blood clot from developing.
I found this program compelling and want to record the information here for reference:
S . . . Surgery Patients.
- General Anesthesia is a risk factor for postsurgical DVT development.
- All surgeries are associated with risk of DVT/General and orthopedic surgeries are associated with a higher risk of developing DVT and PE (pulmonary embolus) than other types of surgery.
- Total knee or hip replacement and hip fracture orthopedic procedures are associated with the highest postsurgical (within 1 to 2 weeks) risk of DV--over 50%.
- Cancer Patients
- Chemotherapy, radiotherapy, central venous catheters, and surgery contribute to the increased risk of VTE (venous thromboembolism) in patients with cancer.
- Tamoxifen or hormone replacement therapy are risk factors for DVT
- Tumors may also cause obstruction which can contribute to venous stasis.
- Cardiovascular Patients
- Acute myocardial infarction (AMI), ischemic and non-ischemic cardiomyopahy, congestive heart failure (CHF) secondary to valvular disease, and chronic idiopathic dilated cardiomyopathy may increase the risk.
- Modifiable Risk Factor
- Weight loss may decrease risk
- Acute exacerbation of chronic obstructive pulmonary disease (COPD), adult respiratory distress syndrome, moderate to severe community-acquired or nosocomial pneumonia, lung cancer, interstitial lung disease, or pulmonary hypertension are associated with increased risk.
- Bed rest, frailty, and immobility features often associated with advanced age, predispose patients to venous stasis.
- Advancing age (older than 40 years) is a risk factor for VTE.
- As the population ages, the number of cases of VTE is expected to increase.
- Infection Patients
- Disseminated infections, sepsis, and serious systemic infections, including urinary tract (UTI), complicated skin and skin structure, pneumonia, and abdominal infections may lead to increased risk of DVT.
- Inflammatory Disorder Patients
- Disorders such as systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD) are associated with an increased risk of IBD.
- Immobile/ICU Patients
- Venous stasis of the lower limbs may predispose a patient to thrombosis formation
- Patients confined to bedrest for fewer than 5 days had a 21% occurrence of VTE compared to a 36% occurrence in patients on bedrest for over 10 days. [There is no source citation given for these statistics on the flyer.]
- Incidence of DVT in stroke patients with a paralyzed lower limb exceeds 50%. [No source cited.]
- Increased risk in ICU patients with medical disorders.
- Trauma Patients
- Patients with major trauma who do not receive thromboprophylaxis have a 50% risk of DVT. [No source is cited for this statistic.]
- Multiple injuries and lower extremity or pelvic fractures are associated with a higher risk of VTE.
- Thrombophilia/Thromboembolism History Patients
- Prior history of DVT/PE confers risk of a future event.
- As many as 20% of patients with confirmed thromboembolic disease have a history of DVT or PE.
- Patients with an acquired or genetic predisposition to hypercoagulable states are at risk for VTE.
Patients--be concerned about pain and swelling in your legs. Often a blood clot will first appear in the back of one of the lower legs. This can occur while you are in the hospital or even a few weeks after you get home. Also be concerned about any sharp pain in the chest, wheezing breath sounds and frequent moist cough; those signs could suggest a small blood clot has gone to the lungs.
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