Determination of Risk Factors for Venous Thromboembolism by an Adapted Caprini Scoring System in Surgical Patients.

Bui My Hanh,Duong Tuan Duc,Nguyen Thi Nga,Dinh-Toi Chu,Nguyen Truong Son,Tran Tien Hung,Nguyen Hoang Hiep,Hoang Thi Hong Xuyen,Le Quang Cuong,Duong Duc Hung,Tran Binh Giang

doi:10.3390/jpm9030036

Abstract

Venous thromboembolism (VTE) is a frequent preventable complication among surgical patients. Precise risk assessment is a necessary step for providing appropriate thromboprophylaxis and reducing mortality as well as morbidity caused by VTE. We carried out this work to define the rate of VTE postoperatively, following a Caprini score, and to determine VTE risk factors through a modified Caprini risk scoring system. This multicenter, observational, cohort study involved 2,790,027 patients who underwent surgery in four Vietnamese hospitals from 01/2017 to 12/2018. All patients who were evaluated before surgery by using a Caprini risk assessment model (RAM) and monitored within 90 days after surgery. The endpoint of the study was ultrasound-confirmed VTE. Our data showed that the 90-day postoperative VTE was found in 3068 patients. Most of VTE (46.97%) cases were found in the highest risk group (Caprini score > 5). A total of 37.19% were observed in the high risk group, while the rest (15.84%) were from low to moderate risk groups. The likelihood of occurring VTE was heightened 2.83 times for patients with a Caprini score of 3–4, 4.83 times for a Caprini score of 5–6, 8.84 times for a score of 7–8, and 11.42 times for a score of >8, comparing to ones with a score of 0 to 2 (all p values < 0.05). Thus, the frequency of postoperative VTE rises substantially, according to the advanced Caprini score. Further categorizing patients among the highest risk group need delivering more appropriate thromboprophylaxis.

Highlights

Venous thromboembolism (VTE) (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) is a prevalent complication, which may lead to morbidity and mortality (MAM) in patients ofJ
A total of 2,790,027 patients who experienced either elective or emergency surgeries were enrolled in our study
Venous thromboembolism remained a common postoperative complication, with numerous risk factors being conducive to the occurrence of the disease, VTE prophylaxis was shown to be underused, which is mainly because of limited awareness among the health care setting relating to the determination of high-risk patients who are in need of thromboprophylaxis [13]

Summary

Introduction

Venous thromboembolism (VTE) (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) is a prevalent complication, which may lead to morbidity and mortality (MAM) in patients ofJ. Venous thromboembolism (VTE) (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) is a prevalent complication, which may lead to morbidity and mortality (MAM) in patients of. Med. 2019, 9, 36 both general medical and surgical conditions. The affliction regarding the disease is significant, as the annual rate of VTE in the Caucasian population is about 1 to 2 per 1000 patients each year [1,2]

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