Characteristics of the RAMs
| Name of RAM . | No. of risk factors . | Risk factors . | Weighing points of risk factors . | Defined cutoffs for risk groups . |
|---|---|---|---|---|
| RAMs developed based on individual patient data | ||||
| MEDENOX RAM22 | 5 | • Age, prior VTE, active cancer, acute infectious disease, chronic respiratory disease (primary diagnosis of COPD) | Not described | Not described |
| Weill Engerer RAM32 | 7 | • Age, prior VTE, chronic edema of lower limbs, chronic heart failure, current lower-limb paralysis, bed rest/immobilized, congestive heart failure | Not described | Not described |
| Yale RAM34 | 8 | • Age, oral contraceptive/HRT, varicose veins, type II diabetes mellitus, nursing home, chemotherapy, corticosteroids, angina | Not described | Not described |
| IMPROVE RAM31 | 7 | • Previous VTE • Known thrombophilia, current lower-limb paralysis, current cancer • Immobilized ≥7 d, ICU/CCU stay, age >60 y | • 3 • 2 points each • 1 point each | • According to Rosenberg et al28 : 0-2, low risk; ≥3, high risk • According to Mahan et al20 : 0-1, low risk; 2-3, intermediate risk; ≥4, high risk |
| Multivariable RAM29 | 13 | • Age, length of stay, sex, primary diagnosis, cancer, inflammatory bowel disease, obesity, central venous catheter, inherited thrombophilia, steroid use, mechanical ventilation, active chemotherapy, and urinary catheters | None | No cutoff available |
| 4-Element RAM33 | 4 | • Previous VTE, an order for bed rest, peripherally inserted central venous catheterization line, cancer diagnosis | 1 point each | • 0 low risk • ≥1 high risk |
| Full logistic RAM33 | 86 | Risk factors were not provided by systematic review; see reference for all risk factors | None | No cutoff available |
| RAMs developed based on consensus approaches, data from the literature, and clinical expertise | ||||
| Caprini RAM24 | 39 | • Stroke; multiple trauma; elective major lower extremity arthroplasty; hip, pelvis or leg fracture; acute spinal cord injury (paralysis) • Age (≥75 y); history of VTE; positive factor V Leiden; positive prothrombin G20210A; elevated serum homocysteine; positive lupus anticoagulant; other congenital or acquired thrombophilia; HIT; family history of VTE; elevated anticardiolipin antibodies • Age (61-74 y); central venous access; arthroscopic surgery; major surgery; malignancy; laparoscopic procedure ≥45 min; patient confined to bed; immobilizing plaster cast • Age (41-60 y); acute myocardial infarction; heart failure; varicose veins; obesity (BMI ≥ 25); inflammatory bowel disease; sepsis; COPD or abnormal pulmonary function; severe lung disease; oral contraceptives or HRT; pregnancy or postpartum; history of unexpected stillborn infant, recurrent spontaneous abortion (≥3), premature birth with toxemia or growth-restricted infant; medical patient currently at bed rest; minor surgery planned; history of prior major surgery; swollen legs | • 5 points each • 3 points each • 2 points each • 1 point each | • According to Zhou et al36 and Zhou et al35 : 0-1, low risk; 2, intermediate risk; 3-4, high risk; >5, highest risk • According to Abdel-Razeq et al21 : ≥2, low risk; 3-4, moderate risk high; ≥5, high risk |
| Cohen RAM25 | Not described | Not described | Not described | Not described |
| Samama RAM30 | Not described | Not described | Not described | Not described |
| Rocha RAM37 | Not described | Not described | Not described | Not described |
| McCaffrey RAM26 | Not described | Not described | Not described | Not described |
| Kucher RAM39 | 8 | • Cancer, prior VTE, hypercoagulability • Major surgery • Bed rest, age >70 y, obesity (BMI > 30), HRT/oral contraceptive pill | • 3 points each • 2 points • 1 point each | • According to Kucher et al39 : 1-3, low risk; ≥4 points, high risk • According to Woller et al33 : 1-2, low risk; ≥3, high risk |
| Padua RAM23 | 11 | • Active cancer, previous VTE (with exclusion of superficial vein thrombosis), reduced mobility, known thrombophilia • Recent (≥1 mo) trauma and/or surgery • Elderly age (≥70 y), heart and/or respiratory failure, acute myocardial infarction or ischemic stroke, acute infection and/or rheumatologic disorder, obesity (BMI ≥ 30), ongoing hormonal treatment | • 3 points each • 2 points • 1 point each | • <4, low risk • ≥4, high risk |
| Geneva RAM27 | 19 | • Cardiac failure, respiratory failure, recent stroke (<3 mo), recent myocardial infarction (<4 wk), acute infectious disease (including sepsis), acute rheumatic disease, active cancer, myeloproliferative syndrome, nephrotic syndrome, prior VTE, known hypercoagulable state • Immobilization (complete bed rest or inability to walk for >30 min/d) for >3 d, recent travel >6 h, age > 60 y, BMI > 30, chronic venous insufficiency, pregnancy, hormonal therapy, dehydration (assessed subjectively by the treating physician) | • 2 points each • 1 point each | • 1-2, low risk • ≥3, high risk |
| Name of RAM . | No. of risk factors . | Risk factors . | Weighing points of risk factors . | Defined cutoffs for risk groups . |
|---|---|---|---|---|
| RAMs developed based on individual patient data | ||||
| MEDENOX RAM22 | 5 | • Age, prior VTE, active cancer, acute infectious disease, chronic respiratory disease (primary diagnosis of COPD) | Not described | Not described |
| Weill Engerer RAM32 | 7 | • Age, prior VTE, chronic edema of lower limbs, chronic heart failure, current lower-limb paralysis, bed rest/immobilized, congestive heart failure | Not described | Not described |
| Yale RAM34 | 8 | • Age, oral contraceptive/HRT, varicose veins, type II diabetes mellitus, nursing home, chemotherapy, corticosteroids, angina | Not described | Not described |
| IMPROVE RAM31 | 7 | • Previous VTE • Known thrombophilia, current lower-limb paralysis, current cancer • Immobilized ≥7 d, ICU/CCU stay, age >60 y | • 3 • 2 points each • 1 point each | • According to Rosenberg et al28 : 0-2, low risk; ≥3, high risk • According to Mahan et al20 : 0-1, low risk; 2-3, intermediate risk; ≥4, high risk |
| Multivariable RAM29 | 13 | • Age, length of stay, sex, primary diagnosis, cancer, inflammatory bowel disease, obesity, central venous catheter, inherited thrombophilia, steroid use, mechanical ventilation, active chemotherapy, and urinary catheters | None | No cutoff available |
| 4-Element RAM33 | 4 | • Previous VTE, an order for bed rest, peripherally inserted central venous catheterization line, cancer diagnosis | 1 point each | • 0 low risk • ≥1 high risk |
| Full logistic RAM33 | 86 | Risk factors were not provided by systematic review; see reference for all risk factors | None | No cutoff available |
| RAMs developed based on consensus approaches, data from the literature, and clinical expertise | ||||
| Caprini RAM24 | 39 | • Stroke; multiple trauma; elective major lower extremity arthroplasty; hip, pelvis or leg fracture; acute spinal cord injury (paralysis) • Age (≥75 y); history of VTE; positive factor V Leiden; positive prothrombin G20210A; elevated serum homocysteine; positive lupus anticoagulant; other congenital or acquired thrombophilia; HIT; family history of VTE; elevated anticardiolipin antibodies • Age (61-74 y); central venous access; arthroscopic surgery; major surgery; malignancy; laparoscopic procedure ≥45 min; patient confined to bed; immobilizing plaster cast • Age (41-60 y); acute myocardial infarction; heart failure; varicose veins; obesity (BMI ≥ 25); inflammatory bowel disease; sepsis; COPD or abnormal pulmonary function; severe lung disease; oral contraceptives or HRT; pregnancy or postpartum; history of unexpected stillborn infant, recurrent spontaneous abortion (≥3), premature birth with toxemia or growth-restricted infant; medical patient currently at bed rest; minor surgery planned; history of prior major surgery; swollen legs | • 5 points each • 3 points each • 2 points each • 1 point each | • According to Zhou et al36 and Zhou et al35 : 0-1, low risk; 2, intermediate risk; 3-4, high risk; >5, highest risk • According to Abdel-Razeq et al21 : ≥2, low risk; 3-4, moderate risk high; ≥5, high risk |
| Cohen RAM25 | Not described | Not described | Not described | Not described |
| Samama RAM30 | Not described | Not described | Not described | Not described |
| Rocha RAM37 | Not described | Not described | Not described | Not described |
| McCaffrey RAM26 | Not described | Not described | Not described | Not described |
| Kucher RAM39 | 8 | • Cancer, prior VTE, hypercoagulability • Major surgery • Bed rest, age >70 y, obesity (BMI > 30), HRT/oral contraceptive pill | • 3 points each • 2 points • 1 point each | • According to Kucher et al39 : 1-3, low risk; ≥4 points, high risk • According to Woller et al33 : 1-2, low risk; ≥3, high risk |
| Padua RAM23 | 11 | • Active cancer, previous VTE (with exclusion of superficial vein thrombosis), reduced mobility, known thrombophilia • Recent (≥1 mo) trauma and/or surgery • Elderly age (≥70 y), heart and/or respiratory failure, acute myocardial infarction or ischemic stroke, acute infection and/or rheumatologic disorder, obesity (BMI ≥ 30), ongoing hormonal treatment | • 3 points each • 2 points • 1 point each | • <4, low risk • ≥4, high risk |
| Geneva RAM27 | 19 | • Cardiac failure, respiratory failure, recent stroke (<3 mo), recent myocardial infarction (<4 wk), acute infectious disease (including sepsis), acute rheumatic disease, active cancer, myeloproliferative syndrome, nephrotic syndrome, prior VTE, known hypercoagulable state • Immobilization (complete bed rest or inability to walk for >30 min/d) for >3 d, recent travel >6 h, age > 60 y, BMI > 30, chronic venous insufficiency, pregnancy, hormonal therapy, dehydration (assessed subjectively by the treating physician) | • 2 points each • 1 point each | • 1-2, low risk • ≥3, high risk |
BMI, body mass index; CCU, critical care unit; COPD, chronic obstructive pulmonary disease; HIT, heparin-induced thrombocytopenia; HRT, hormone replacement therapy; ICU, intensive care unit.