MDCalc

Thrombosis Risk Prediction Following Cast Immobilization (TRiP(cast)) Score

Predicts risk of VTE in patients with lower limb trauma.

Use this tool to determine 3-month risk of VTE in adult patients with lower limb trauma that requires immobilization.

Trauma

Choose the most severe trauma.
Low-risk trauma
  • Single malleolar ankle fracture.
  • Patellar dislocation.
  • (Meta)Tarsal bone(s) or forefoot fracture.
  • Non-severe knee sprain or ankle sprain (grade 1 or 2).
  • Significant muscle injury.
    • Intermediate-risk trauma
  • Bi or trimalleolar ankle fracture.
  • Patellar fracture.
  • Ankle dislocation, Lisfranc injury.
  • Severe knee sprain (with edema/hemarthrosis).
  • Severe ankle sprain (grade 3).
    • High-risk trauma
  • Fibula and/or tibia shaft fracture.
  • Tibial plateau fracture.
  • Achilles tendon rupture.

    • Immobilization

    Age

    Sex

    BMI

    Family history of VTE

    (first-degree relative)

    Personal history of VTE or known major thrombophilia

    Current use of oral contraceptives or estrogenic hormone therapy

    Cancer diagnosis within the past 5 years

    Pregnancy or puerperium

    Other immobilization within the past 3 months

    Hospital admission, bedridden or flight >6 hours, and/or lower limb paralysis.

    Surgery within the past 3 months

    Comorbidity

    Heart failure, rheumatoid arthritis, chronic kidney disease, COPD, and/or IBD.

    Chronic venous insufficiency

    (varicose veins)

    Result:

    Please fill out required fields.
    Management
    • A score of ≥7 suggests that the patient is at high risk for VTE. 
    • Anticoagulation therapy can be considered in this patient, after ensuring that an adequate risk and benefit conversation is held.

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