Risk assessment as a guide to thrombosis prophylaxis.

PURPOSE OF REVIEW: This review discusses the current status of individual thrombosis risk assessment as an alternative to applying prophylaxis to broad groups in an attempt to simplify the process. Complete assessment is necessary in order to provide the proper type, duration, and intensity of prophylaxis, especially following discharge. RECENT FINDINGS: The concept of weighting risk factors to obtain a score has been used by some to guide prophylactic decisions for 20 years. This approach was thought to be intuitively correct despite not having been prospectively validated. During the past years, several studies have appeared linking the score to clinically relevant, imaging-proven venous thromboembolism events. In one study, 12.5% of patients with a score higher than 8 developed proven venous thromboembolism events within 60 days postoperatively. SUMMARY: The use of this score can suggest appropriate prophylaxis for surgical patients, especially those at high risk following hospital discharge.