A Prospective Study Evaluating Patterns of Responses to the Caprini Score to Prevent Venous Thromboembolism After Interventional Treatment for Varicose Veins

Abstract

Background Venous thromboembolism (VTE) is a critical complication of varicose vein treatments. The Caprini Score (CS) is an established tool to assess patients’ VTE risks. One disadvantage is the number of questions required, some of them referring to a low incidence of disease, even lower in patients seeking an elective procedure. These elements take time and may result in filling errors if the CS is not filled out by a properly trained health professional. Objective To establish a response pattern in CS, with emphasis on questions that usually have a negative answer and propose a simpler adaptative digital version without changing the original structure of the tool. Methods two hundred and twenty-seven patients in the pre-surgical treatment of varicose veins were enrolled prospectively and submitted to the CS evaluation. Results The pattern of dichotomous responses could be divided arbitrarily into four subgroups considering the percentage of positive responses: none (11 items), less than 3% (13 items), between 3% and 20% (5 items), and more than 20% (8 items). Of the 12 CS questions related to illnesses that occurred in the last month, ten had had no responses, and 2 were less than 3%. Conclusion There is a pattern in the CS responses of patients with an indication of surgical treatment of varicose veins. Many of the CS questions are not helpful in this scenario and may result in filling errors performed by untrained providers. An adaptative version of the CS might benefit varicose veins surgery VTE risk stratification

Current state of the problem of risk assessment and prevention of venous thromboembolic complications after thermal obliteration of superficial veins

“…Первые результаты проспективного наблюдательного исследования CAPSIVS подтвердили достоверную положительную корреляцию между баллами и частотой развития бессимптомных и симптоматических ВТЭО, которая достигала 5,4% преимущественно за счет ЭТИТ и субклинических окклюзий мышечных вен голени, у 700 пациентов после современных малоинвазивных операций на поверхностных венах [14]. С целью упрощения заполнения шкалы была произведена оценка наиболее распространенных факторов риска у 227 лиц с варикозной болезнью, среди которых оказались возраст 41-60 и 61-74 года, избыточная масса тела, отек нижних конечностей, малое или большое хирургическое вмешательство, прием половых стероидов, семейная история ВТЭО, отягощенный акушерский анамнез, рак, ТГВ, инфекционное заболевание [23].…”