Validation of the Caprini Venous Thromboembolism Risk Assessment Model in Critically Ill Surgical Patients

Abstract

author's patients other than EVAR over the time period studied. These include more rapid control of hemorrhage, permissive hypotension, use of decompressive laparotomy, better blood product resuscitation with potentially more use of fresh frozen plasma. This type of study, therefore, has multiple potential confounders despite best efforts to control for them. It actually cannot be used as justification for an endovascular first approach for rAAA when they are randomized trials where nonselective use of EVAR for rAAA does not yield a survival advantage (Improve trial investigators. BMJ 2014; 348:F7661). Overall, EVAR for treatment of rAAA should be considered another tool in the toolbox of the surgeon treating a rAAA but is not necessarily the only tool and may not be the best tool for all patients.

Influence of Enhanced Recovery After Surgery (ERAS) on Patients Receiving Lung Resection: A Retrospective Study with 1,749 Cases

“…Moreover, the specialized nurse recorded the achievements. The nurse of VTE management group evaluated the VTE risk via the Caprini Assessment Scale (10,11) and used low-molecular-weight heparin (LMWH) perioperatively for VTE prophylaxis (12). atelectasis documented clinically or radiographically; 3) respiratory/heart failure or adult breathing distress syndrome (ADRS); 4) mechanical ventilation > 48 h; 5) > 7 days air leak; 6) pulmonary embolism; 7) empyema; 8) chyle leak; 9) bronchopleural stula; 10) Back to ICU.…”

Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients

“…This RAM was first proposed in the early 1990s and has since been extensively modified and validated in several different patient populations, including general, vascular, otolaryngology, and critically ill and trauma patients. 11,14,15 The 2005 Caprini score has been implemented and integrated into the electronic medical record at many institutions. 10,39 The Caprini Score is a weighed RAM, in which risk is estimated by obtaining a score after assessment of the patient for 40 individual risk factors.…”

“…44 Obi et al conducted a retrospective cohort study of risk stratification with the Caprini RAM of 4,844 patients in a surgical ICU population. 15 The study looked at VTE events that occurred during the index hospitalization, and no formal screening protocol was in place for asymptomatic patients. The 2005 Caprini score identified a sevenfold variation in VTE risk among surgical ICU patients, and 8.6% of highest risk patients (Caprini >8) had a VTE event during their inpatient admission.…”

“…10 Despite humble beginnings, the 2005 Caprini score has been validated in thousands of surgical patients, including otolaryngology head and neck, 11 plastic and reconstructive surgery patients, 12 gynecologic oncology, 13 general surgery, vascular surgery, and urology, 14 and patients in the surgical ICU. 15 Other RAMs have been designed using rigorous statistical methods but have not been rigorously externally validated, including the Rogers Score 16 based on data from the VA patient safety study, the Pannucci Outpatient Score, 17 based on data for outpatient surgeries in the National Surgical Quality Improvement Project database, and the Pannucci Inpatient Score 18 based on statewide quality collaborative data from Michigan. Evidence for their effectiveness, while increasingly available and rigorous, is still inadequate, as evidenced by the lack of consensus between specialty-specific and national guidelines.…”

Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty

“…VTE treatment presents risks including heparin-induced thrombocytopenia and bleeding complications by itself. There are various risk assessment models (RAMs) for VTE in Western countries to stratify patients based on risk factors and help to deliver individualized VTE prophylaxis [13][14][15] , but there is no clear data about VTE in Chinese patients with diabetes following THA or TKA. The aim of our study was to present the incidence of DVT among people with diabetes following THA or TKA and investigate its associated risk factors in current clinical practice.…”