Constans Score
Original Editor - Carina Therese Magtibay
Top Contributors - Carina Therese Magtibay
Objective
The Constans Score is used to determine the clinical probability of Upper Extremity DVT. [1]When used in conjunction with age-adjusted D-dimer testing, it helps in assessing UEDVT risk of patients, thus guiding the need for further imaging.[2]
Intended Population
The Constans Score was developed for patients with clinically suspected UEDVT.
Method of Use
| Symptoms | Points |
|---|---|
| Venous material including catheter in a subclavian or jugular vein or pacemaker | +1 |
| Localised pain | +1 |
| Unilateral pitting oedema | +1 |
| Other diagnosis at least as plausible | -1 |
| Risk for UEDVT | Total Score |
|---|---|
| Low risk | ≤0 |
| Intermediate risk | 1 |
| High risk | ≥2 |
Evidence
The Constans score was validated in both internal (103 patients) and external (214 patients) cohorts of patients with suspected UEDVT. In low-risk patients, the prevalence of UEDVT was 9-13% while in high-risk patients, it was 64-70%, indicating its ability to stratify according to risk levels. However, the area under the curve (AUC) ranged from 0.68 to 0.78, suggesting only moderate diagnostic accuracy. [3]
In a study by Van Es et al. (2017), the Constans score demonstrated good accuracy in differentiating between patients with and without UEDVT, with a c-statistic of 0.81 and a 95% confidence interval of 0.76–0.85.[2]
References
- ↑ Bosch FT, Nisio MD, Büller HR, van Es N. Diagnostic and therapeutic management of upper extremity deep vein thrombosis. Journal of Clinical Medicine. 2020 Jul 1;9(7):2069.
- ↑ 2.0 2.1 van Es N, Bleker SM, Di Nisio M, Kleinjan A, Beyer‐Westendorf J, Camporese G, Aggarwal A, Verhamme P, Righini M, Büller HR, Bossuyt PM. Improving the diagnostic management of upper extremity deep vein thrombosis. Journal of Thrombosis and Haemostasis. 2017 Jan;15(1):66-73.
- ↑ Constans J, Salmi LR, Sevestre-Pietri MA, Perusat S, Nguon M, Degeilh M, Labarere J, Gattolliat O, Boulon C, Laroche JP, Le Roux P. A clinical prediction score for upper extremity deep venous thrombosis. Thrombosis and haemostasis. 2008;99(01):202-7.