Understanding Your Blood Clot Risk

Knowing your risk level for deep vein thrombosis could save your life. Center for Vein Restoration’s Dr. Marlin Schul explains why.

By Dr. Marlin W. Schul, MD, RVT, DABVLM

In 2005, the Senate passed a resolution declaring March Blood Clot Awareness Month in the hopes of raising public recognition of the dangers of deep vein thrombosis (DVT), a blood clot that forms in the leg. DVT may be a potentially life-threatening condition if the clot travels to the lung, where it could cause a fatal pulmonary embolism (PE).

One in 20 people will experience a DVT in their lifetime. Ten times more people suffer from venous insufficiency than from peripheral arterial disease. Venous malformations, superficial venous reflux (varicose veins), and blood clots all classify as venous insufficiency and can happen at any age. Even famous athletes like Serena Williams have been stricken by blood clots. At the same time, we are seeing a pandemic of venous stasis leg ulcers, with 20,000 new cases each year.

How Many People are Hospitalized with DVT and PE?

Half a million people are hospitalized annually with DVT/PE. Although that number represents a decline in hospitalizations, the actual number of DVT events is likely under-reported because medications now manage blood clot risk and prevent many hospitalizations.

PE has been cited as the third most common preventable cause of death during hospitalizations. Sadly, it only takes one blood clot to change a life or kill someone. The danger is so acute that the Centers for Medicare and Medicaid Services has declared it an “area of concern.” It coined the term “never events” to emphasize the importance of preventing blood clots while patients are hospitalized. They even go as far as threatening hospitals with non-payment for not taking preventative measures against DVT.

Even if a person survives a DVT, he or she may be left with chronic pain and swelling of the leg. In light of the seriousness of DVT, it’s important you know your chances of a blood clot, especially if you have a planned surgery and/or hospitalization.

Know Your Risk: The Caprini DVT Risk Assessment Tool

Each individual possesses a unique DVT risk based on myriad personal factors. Fortunately, you can assess your risk using the Caprini DVT Risk Assessment Tool. Created by noted DVT expert Dr. Joseph A. Caprini, the tool has been verified in more than 100 clinical trials worldwide that reviewed 250,000 patients.

When you download the tool on your smartphone or computer, you’ll be asked a series of questions, beginning with your age and gender. You’ll also be asked if you have had a broken hip, heart disease, lung disease (like asthma or COPD), or cancer that could change the composition of your blood (skin cancers are excluded).

Other risk factors for DVT include:

• Body mass index (BMI) of over 25

• Confinement to bed rest or having been immobile for a long period

• Having had a major surgery lasting more than 45 minutes

A personal history of DVT further boosts your chances of another, as does a family history of blood clots. Individuals with clotting disorders also stand a higher chance of DVT. Serious infections such as COVID-19 have also caused blood clots.

Although varicose veins have been cited as an independent risk factor for DVT, they are not considered a major indicator of DVT. Nevertheless, superficial venous incompetence must be evaluated when assessing DVT risk.

How is DVT Risk Calculated?

Answering more of the questions in the affirmative ultimately provides you with a score. The higher the score, the more at risk you are. Knowing your score is vital, especially if you are going to be hospitalized. If your doctor knows your risk, he or she can develop strategies to prevent a blood clot in the hospital. These would include wearing compression stockings or using a pneumatic compression pump on your legs that helps move the blood. You might also be given blood thinners to reduce your DVT risk if your score is a higher number.

The Caprini tool is not only a helpful exercise to assess your risk; clinicians can use it to assess a patient's risk, as well. One study of hospitalized patients who later developed DVT/PE estimated nearly half of those cases failed to receive prophylaxis or medication to protect against a blood clot. A risk assessment tool could have prevented a clot from forming by identifying those at greatest risk. Once your risk is evaluated, preventative remedies can then be taken. Risk assessment can make a difference and save your life.