Thromboembolic Risk Assessment and the Efficacy of Enoxaparin Prophylaxis in Excisional Body Contouring Surgery

Hatef, Daniel A.; Kenkel, Jeffrey M.; Nguyen, Michelle; Farkas, Jordan P.; Abtahi, Fatemeh; Rohrich, Rod J.; Brown, Spencer A.

doi:10.1097/prs.0b013e3181773d4a

Cited by 184 publications

(126 citation statements)

References 45 publications

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“…Among these individual VTE RAMs, the Caprini model is the most notable. It has been adopted by many individuals and organizations [17][18][19] and has already been validated in several studies 18,[20][21][22][23][24] . However, most of these validation studies were conducted in surgical patients, despite the fact that the Caprini RAM was designed for use in both medical and surgical patients.…”

Section: Risk Assessment Model (Ram)mentioning

confidence: 99%

Validation of a Venous Thromboembolism Risk Assessment Model in Hospitalized Chinese Patients: A Case-Control Study

Zhou

Wang

et al. 2014

JAT

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Aim: The appropriate selection of hospitalized patients for venous thromboembolism (VTE) prophylaxis is an important unresolved issue. We sought to validate the Caprini model, a famous individual VTE risk assessment model (RAM), in hospitalized Chinese patients. Methods: We performed a retrospective case-control study among unselected hospitalized patients admitted to a comprehensive hospital in China. A total of 347 patients were confirmed to have VTE during hospitalization, and 651 controls were randomly selected to match the patients according to medical service. Both the patients and controls were retrospectively assessed for the risk of VTE using the Caprini RAM. Results: The average Caprini cumulative risk score in the patients was significantly higher than that observed in the controls (4.69±2.58 vs 3.16±1.82, p＜0.0001). Compared with that observed in the low-risk group, a classification of high-risk according to the Caprini model was associated with a 1.65-fold increased risk of VTE (95%CI 1.05-2.61), while that of highest-risk was associated with a 4.84-fold increased risk of VTE (95%CI 3.06-7.64). After further stratifying the highest risk level with a cumulative risk score of ≥ 5 into scores of 5-6, 7-8 and ≥ 9, the patients with a score of 5-6 were found to exhibit a 3.33-fold increased risk of VTE (95%CI 2.06-5.40), those with a score 7-8 exhibited a 9.41-fold increased risk of VTE (95%CI 4.90-18.08) and those with a score of ≥ 9 exhibited a 24.69-fold (95%CI 7.98-76.40) increased risk of VTE compared with their low-risk counterparts. Conclusions: Our study suggests that the Caprini RAM can be used to effectively stratify hospitalized Chinese patients into VTE risk categories based on individual risk factors. The classification of the highest risk level with a cumulative risk score of ≥ 5 provided significantly more clinical information, and further stratification of this group of patients is needed. J Atheroscler Thromb, 2014; 21:261-272.

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Section: Risk Assessment Model (Ram)mentioning

confidence: 99%

Validation of a Venous Thromboembolism Risk Assessment Model in Hospitalized Chinese Patients: A Case-Control Study

Zhou

Wang

et al. 2014

JAT

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“…Other risk factors such as obesity, smoking, estrogen therapy, prolonged bed rest, inherited disorders of coagulation and previous pulmonary embolism are also well accepted in the literature as known risk factors for thromboembolic complications. In addition, hypogonadism, risperidone and testosterone injections have also been shown to correlate with the incidence of deep venous thrombosis and pulmonary embolism in a small number of studies (7,21,24,25,27,(29)(30)(31). Our patient was subject to many of these risk factors.…”

Section: Discussionmentioning

confidence: 90%

“…As a specific complication of body contouring procedures, pulmonary emboli are often seen after long procedures such as abdominoplasty or liposuction (26)(27)(28). They are less commonly seen in mastectomy, yet are still recognized as known complications and have been reported (26).…”

Section: Discussionmentioning

confidence: 99%

“…Shermak et al (7) reported that 100% of the thromboembolic events occurring as complications of various body contouring procedures occurred in patients with a BMI of more than 35 kg/m 2 . A chart review by Hatef et al (27) examining thromboembolic risk assessment in body contouring surgery procedures also noted BMI greater than 30 kg/m 2 to be a significant risk factor for thromboembolic complications. In most recent literature, when stratifying patients based on their level of risk, many studies have adopted this correlation between BMI and thromboembolic complications and include BMI as a predisposing factor in their scoring (32).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral pulmonary emboli after bilateral mastectomy in a 15-year-old boy with hypogonadism: A case report

Piggott¹,

Yazdani²

2010

J Plast Surg

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“…Trata-se do maior grau de recomendação que pode ser atribuído a dados não procedentes de estudos controlados e randomizados. Recentemente, foi demonstrada sua eficiência na estratificação de risco de TVP, onde 89,5% dos eventos tromboembólicos ocorreram em pacientes arrolados no grupo de risco muito alto 15 .…”

Section: Introductionunclassified

Estudo comparativo entre protocolos para profilaxia da trombose venosa profunda: uma nova proposta

Moulim¹,

Sobreira²,

Malgor

et al. 2010

Rev. Bras. Cir. Plást. (Impr.)

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415Estudo comparativo entre protocolos para profilaxia da trombose venosa profunda: uma nova proposta Estudo comparativo entre protocolos para profilaxia da trombose venosa profunda: uma nova proposta Deep venous thrombosis prophylaxis protocols comparative study: a new proposal RESUMO Introdução: O artigo compara os protocolos Davison-Caprini (americano) e Sandri (brasileiro) para profilaxia da trombose venosa profunda (TVP), buscando a elaboração de um novo protocolo, mais abrangente e aplicável. Método: Foi realizado um estudo prospectivo, durante um ano, abrangendo 212 pacientes, comparando os protocolos quanto à estratificação de risco de TVP, e ao tipo de profilaxia indicado. Um novo protocolo foi proposto, aplicado e comparado aos anteriores. Resultados: Obteve-se um novo protocolo, denominado Sandri modificado, que restringe a heparina a um grupo seleto de pacientes, semelhante ao americano, mantendo-se adequado tanto para cirurgias estéticas quanto reparadoras. Conclusões: A baixa adesão, por parte dos cirurgiões plásticos, ao uso rotineiro da profilaxia de TVP, espelha a escassez de informação sobre o tema. O protocolo Sandri modificado busca melhorar a compreensão e a aplicabilidade da profilaxia da TVP na cirurgia plástica. SUMMARY Background:Compare Davison-Caprini (American) and Sandri (Brazilian) protocols for deep vein thrombosis (DVT) prophylaxis, suggesting a new protocol, more comprehensive and applicable. Method: A prospective study was conducted over a year, including 212 patients, comparing the protocols on DVT stratification risk, and the type of prophylaxis indicated. A new protocol was proposed, applied and compared to the previous. Results: The new protocol, modified Sandri, restricts the heparin to a select group of patients, similar to the American protocol, and remains suitable for both aesthetic and reconstructive surgery. Conclusions: The low adhesion of plastic surgeons to the routine use of DVT prophylaxis reflects lack of information concerning this topic. The Sandri modified protocol seeks improvement on the understanding and applicability of DVT prophylaxis in plastic surgery. Descriptors

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Thromboembolic Risk Assessment and the Efficacy of Enoxaparin Prophylaxis in Excisional Body Contouring Surgery

Cited by 184 publications

References 45 publications

Validation of a Venous Thromboembolism Risk Assessment Model in Hospitalized Chinese Patients: A Case-Control Study

Validation of a Venous Thromboembolism Risk Assessment Model in Hospitalized Chinese Patients: A Case-Control Study

Bilateral pulmonary emboli after bilateral mastectomy in a 15-year-old boy with hypogonadism: A case report

Estudo comparativo entre protocolos para profilaxia da trombose venosa profunda: uma nova proposta

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