Completion of the Updated Caprini Risk Assessment Model (2013 Version)

Abstract

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.

Tromboembolismo venoso em pacientes COVID-19

“…Patients who take antithrombotics should be instructed to continue taking them, but should be warned about the risk of drug interactions between the antithrombotics and medications prescribed for COVID-19, in particular antivirals and steroidal and non-steroidal anti-inflammatories. In general, pharmacological VTE prophylaxis is not indicated; however, prophylaxis with low molecular weight heparin (LMWH) can be considered, particularly among patients at increased risk of VTE (Caprini score > 8), [11][12][13][14] as long as they are not at increased risk of bleeding. The preference for LMWH is because of its shorter half-life and fewer drug interactions than direct oral anticoagulants (DOACs).…”

“…Patients in hospital in a serious or critical condition should have prothrombin activity time (PAT), APTT, DD, fibrinogen, and fibrin degradation products measured routinely, since elevation of these markers is associated with worse prognosis and a high prevalence of VTE and death. 3,6,11,[13][14][15][16][17][18][19][20][21] Indications for VDUS should be the same as those for patients without COVID-19 and this examination should only be performed if the result will be decisive for choice of therapeutic management. Elevated DD levels should not be the only factor in deciding to use VDUS.…”

“…[1][2][3][6][7][8] The recommendations presented here are based on international consensuses on prophylaxis and treatment of VTE in patients without COVID-19, 9,10 on editorials, on retrospective studies of cases series, and on expert recommendations and opinions on clinical practice with COVID-19 patients published recently on a fasttrack basis, the majority without peer review. [11][12][13][14] They should therefore be applied on a case-by-case basis by an experienced multidisciplinary team trained in use of these medications and procedures.…”

Perioperative Acute Pulmonary Embolism: A Concise Review with Emphasis on Multidisciplinary Approach

“…It also includes a VTE risk assessment using the Caprini score, which might be useful to categorize patients in a high or very high-risk groups, and such patients must have an appropriate thromboprophylaxis strategy perioperatively. 14…”

“…[7][8][9] The Caprini risk assessment model for the prediction of perioperative VTE has been arguably one of the most utilized tools worldwide. [13][14][15] It has been validated in >250,000 patients across more than100 studies, demonstrating to be consistent, thorough, and efficient while risk stratifying surgical patients during their perioperative period. [13][14][15] In addition, male sex, age >80 years, prolonged immobilization, chronic heart disease, and a lack of perioperative thromboprophylaxis are independent risk factors for early perioperative acute PE-related mortality in a study of 294 patients.…”