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A Practical Guide to Haemostasis


Estimating the Risk of Thrombosis in the Antiphospholipid Syndrome:
  a. The Global Anti-Phospholipid Syndrome Score [GAPSS].
  b. The Adjusted Global Anti-Phospholipid Syndrome Score [aGAPSS].

Introduction:

a. The GAPSS score risk score was developed to identify individuals with Anti-Phospholipid Syndrome [APS] at greater risk of thrombosis and/or pregnancy loss and is derived from a combination of conventional cardiovascular risk factors and the autoimmune antibody profile - including both criteria and non-criteria aPL antibodies - see Comments. 

In the original study, six variables:
  - Arterial hypertension
  - Hyperlipidaemia
  - aCL antibodies
  - LA
  - Anti-β2GPI antibodies
  - aPS/PT [antibodies to solid-phase Prothrombin (aPT) and to the phosphatidylserineprothrombin complex (aPS/PT)
..... were shown to be independent risk actors for thrombosis and pregnancy loss after multivariate analysis.

b. The Adjusted Global Anti-Phospholipid Syndrome Score [aGAPSS] excludes aPS/PT antibodies from the scoring algorithm recognising that these antibodies are not currently included in the criteria for defining APS and not all laboratories routinely test for aPS-PT antibodies. 

The GAPSS Score:


The criteria that comprise the GAPSS score are summarised below:


Select Criteria:

Hyperlipidaemia
3 Points
Arterial Hypertension
1 Point
aCL IgG/IgM
5 Points
Lupus Anticoagulant [LA]
4 Points
aPS/PT IgG/IgM
3 Points


Score

[Max score 16 points]


Interpretation
GAPSS Score
Sensitivity
Specificity
  GAPSS Score 10
0.709
0.793
  GAPSS Score 12
0.578
0.817
  GAPSS Score 15
0.378
0.950



Comments:
The aPL score (aPL-S) [Ref 6] was developed to aid in the prediction of thrombotic events in individuals with APS.  However, it does not take into account conventional risk factors for thrombosis which are included in the GAPSS and aGAPSS algorithms. 

Click HERE to reset the algorithm.


The aGAPSS Algorithm:


Click HERE to access the aGAPSS Algorithm.