The Caprini risk assessment model (RAM) has been validated in over 250 000 patients in more than 100 clinical trials worldwide. Ultimately, appropriate treatment options are dependent on precise completion of the Caprini RAM. As the numerical score increases, the clinical venous thromboembolism rate rises exponentially in every patient group where it has been properly tested. The 2013 Caprini RAM was completed by specially trained medical students via review of the presurgical assessment history, medical clearances, and medical consults. The Caprini RAM was completed for every participant both preoperatively and predischarge to ensure that any changes in the patient's postoperative course were captured by the tool. This process led to the development of completion guidelines to ensure consistency and accuracy of scoring. The 2013 Caprini scoring system provides a consistent, thorough, and efficacious method for risk stratification and selection of prophylaxis for the prevention of venous thrombosis.
Although not uniformly successful, deltoid ligament reconstruction using a tendon graft through appropriate bone tunnels can reconstruct the deltoid ligament and correct the valgus talar tilt. Successful results were achieved when combined with correction of flatfoot deformity, which is considered a necessary part of the procedure.
Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk
assessment. We compared the results of our prospective department protocol to the Caprini
risk assessment model (RAM) retrospectively in this study group. Our goal was to determine
whether the department protocol or the Caprini score would identify venous thromboembolism
(VTE) events after total joint replacement. A secondary purpose was to validate the 2013
Caprini RAM in joint arthroplasty and determine whether patients with VTE would be
accurately identified using the Caprini score. A total of 1078 patients met inclusion
criteria. A Caprini score of 10 or greater is considered high risk and a score of 9 or
less is considered low risk. The 2013 version of the Caprini RAM retrospectively
stratified 7 of the 8 VTE events correctly, while only 1 VTE was identified with the
prospective department protocol. This tool provided a consistent, accurate, and
efficacious method for risk stratification and selection of chemoprophylaxis.
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