Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Michigan risk score calculator evaluates the risk of developing thrombosis associated with a peripherally inserted central catheter (PICC) by assessing five key clinical factors. This tool helps determine the likelihood of venous thromboembolism by assigning scores to each factor and calculating a total risk score.

Here's how the scoring works for each input:

- Presence of another central venous catheter: If present, score 1. Otherwise, score 0.
- White blood cell count greater than 12.0 × 10^9/mcL: If elevated, score 1. Otherwise, score 0.
- Number of PICC lumens:
  - For 1 lumen, score 0.
  - For 2 lumens, score 2.
  - For 3-4 lumens, score 3.
- History of venous thromboembolism:
  - If never, score 0.
  - If more than 30 days prior, score 1.
  - If within 30 days, score 2.
- Active cancer status: If actively present, score 3. Otherwise, score 0.

The total risk score is calculated by summing the scores for each input. Based on this aggregated score, the risk of thrombosis is interpreted into different classes:

- Class I: A total score of 0 conveys a minimal risk, with a likelihood of thrombosis at 0.9%.
- Class II: Scores between 1 to 2 suggest a slightly higher risk, with a probability of 1.6%.
- Class III: Scores between 3 to 4 indicate a moderate risk, with a 2.7% chance of thrombosis.
- Class IV: A score of 5 or above signifies the highest risk, with a 4.7% likelihood of developing thrombosis.

By methodically evaluating each clinical input, healthcare professionals can effectively categorize patients' thrombosis risk levels and guide clinical decisions accordingly.

The Michigan Risk Score for Peripherally Inserted Central Catheter-Associated Thrombosis (PICC-AT) is a clinical calculator used to assess the risk of thrombosis in patients who have a peripherally inserted central catheter (PICC). This scoring system is particularly applicable to hospitalized adult patients who have a PICC, as they are at an increased risk of developing thrombosis. 

The clinical utility of the Michigan Risk Score is to aid clinicians in identifying patients at high risk of PICC-associated thrombosis, thereby guiding decisions about prophylactic anticoagulation and informing discussions about the risks and benefits of PICC placement. 

Exclusion criteria for the use of this calculator may include patients who already have a diagnosed thrombosis, those with contraindications to anticoagulation, and patients who do not have a PICC.

Michigan risk score for peripherally inserted central catheter-associated thrombosis

Catheter-related thrombosis

Background

Overview

Guidelines

Key sources

Diagnostic investigations

Medical management

Nonpharmacologic interventions

Specific circumstances

Preventative measures