Stratification of venous thromboembolism risk in burn patients by Caprini score

Abstract

BackgroundThe purpose of the research was to determine the efficacy of the Caprini risk assessment model for the guidance of prophylactic treatments for a 3-year period in the burn center of the Inner Mongolia region. MethodsFrom July 2014 to August 2017, the Caprini score for every admitted patient was calculated to evaluate venous thromboembolism (VTE) risk. Subjects with a Caprini score between 0 and 2 were not administered a chemical VTE prophylaxis, and subjects with a score of 3 and above were administered low-molecular-weight heparin (LMWH). Demographic information, abbreviated burn severity index (ABSI) score, body mass index (BMI), Caprini score, full-thickness total body surface area (TBSA), overall TBSA, day of ambulation, hospital stay, inhalation injury, electrical burn, central venous catheters, and operations were noted for analysis. ResultsOf 1939 inpatients during the study period, 13 patients (0.67%) had VTE complications. The interval from injury to VTE diagnosis was 13.9±8.7 days. Among patients (n=1131) with a Caprini score between 0 and 2, two patients (0.18%) had VTE. A total of 792 patients received LMWH thromboprophylaxis; 11 patients had VTE complications, and among them, one patient (0.13%) developed heparin-induced thrombocytopenia and two patients (0.25%) developed major bleeding. VTE (8.82%) occurred most commonly in the Caprini score >8 group. Age, Caprini score, ABSI score, overall and full-thickness TBSA, central venous catheters, day of ambulation, and hospital stay in patients with VTE (n=11) were significantly higher than those (n=781) without VTE (p<0.05). ConclusionsCaprini score allows for informed decision-making regarding prophylaxis strategies. Early ambulation and mechanical prophylaxis are recommended for patients predisposed to VTE.