New risk assessment scorecard helps physicians prevent blood clots in patients following childbirth

Montefiore Medical CenterMay 8 2013

A new risk assessment scorecard helped physicians significantly improve their ability to identify at-risk patients following childbirth and provide preventive treatment options for life-threatening blood clots, according to a study conducted by researchers at Montefiore Medical Center. At-risk patients with completed scorecards were 2.6 times more likely to receive preventive treatment to reduce serious clots, known as venous thromboembolisms (VTEs), than those who did not. The data were presented today in New Orleans at the annual meeting of the American College of Obstetricians and Gynecologists.

This study included three phases - the initial one evaluated completion of the scorecard in 140 patients followed by a two-month campaign to educate doctors about using the scorecard and then a second evaluation of 133 patients. The scorecard, which was created by Montefiore researchers, includes 16 risk criteria associated with VTE based on guidelines from the Royal College of Obstetricians and Gynecologists. Instruction on how to use the scorecard was provided through interdisciplinary team rounds, Grand Rounds speakers, endorsement of the project from department leaders and "spot checks" with biweekly high-level metrics.

Overall, results showed a significant increase in scorecard completion following the educational campaign in at-risk patients (20% vs. 79%) and all patients (15.7% vs. 67.7%). Similar rates of increased risk of VTE were identified in both groups (31.4% vs. 28.6%).

"Pregnancy significantly increases a woman's risk of VTE and the condition is one of the leading causes of mortality for these patients, making this study and the use of a scorecard to identify those at risk extremely important," said Cynthia Chazotte, M.D., vice chair, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, and professor, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine of Yeshiva University. "We're extremely pleased with the results of the study and we highly recommend that doctors use the scorecard with their postpartum patients."