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

Obi, Andrea; Pannucci, Christopher J.; Nackashi, Andrew; Abdullah, Newaj; Alvárez, Rafael; Bahl, Vinita; Wakefield, Thomas W.; Henke, Peter K.

doi:10.1001/jamasurg.2015.1841

Cited by 142 publications

(82 citation statements)

References 38 publications

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“…67 The extensively validated 2005 Caprini score is known to identify a 5-to 20-fold variation in venous thromboembolism risk among patients undergoing plastic and reconstructive surgery 54 ; general, vascular, or urologic surgery 68 ; otolaryngology head and neck surgery 69 ; gynecologic oncology surgery 70 ; and patients in the surgical intensive care unit. 71 As high variability in venous thromboembolism risk exists in the overall population, data were considered at both the population level (Fig. 7) and in a risk-stratified fashion (Figs.…”

Section: Target Questions 3 and 4: What Is The Effectiveness And Bleementioning

confidence: 99%

Benefits and Risks of Prophylaxis for Deep Venous Thrombosis and Pulmonary Embolus in Plastic Surgery

Pannucci¹,

MacDonald

Ariyan³

et al. 2016

Plastic and Reconstructive Surgery

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125

116

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Section: Target Questions 3 and 4: What Is The Effectiveness And Bleementioning

confidence: 99%

Benefits and Risks of Prophylaxis for Deep Venous Thrombosis and Pulmonary Embolus in Plastic Surgery

Pannucci¹,

MacDonald

Ariyan³

et al. 2016

Plastic and Reconstructive Surgery

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125

116

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“…Infection has been linked to the development of VTE [8910]. Infection can have direct consequences and indirect effects, the latter being due to the effect on the immune system.…”

Section: Discussionmentioning

confidence: 99%

Anatomic and clinical risk factors for pulmonary embolism in patients with deep venous thrombosis of the lower extremity

Paik

Joh

2017

Ann Surg Treat Res

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PurposeIliac vein compression is a known culprit of deep vein thrombosis (DVT). In contrast, the compression may prevent the pulmonary embolism (PE). The aim of this study was to evaluate the anatomic and clinical risk factors of PE in patients with lower extremity DVT.MethodsPE was evaluated using chest computed tomography in patients with lower extremity DVT. The patients were classified into group I (DVT without PE) and group II (DVT with PE) and analyzed to clarify the anatomic and clinical risk factors associated with PE in patients with DVT. As the anatomic factor, the shortest length between the common iliac artery (CIA) and spinal body (SB) was measured. Statistical analyses utilized the multivariable logistic regression model, and receiver operating characteristic (ROC) curve analysis.ResultsWe examined 114 patients (age; 62.7 ± 16.9 years, 41.7% men) with DVT with/without PE. The prevalence of concurrent DVT with PE was 52.6%. Blood tests showed no difference between the 2 groups. Of all the assessed patients' characteristics, only infection was significantly and independently associated with PE (P = 0.04). The shortest length between CIA and SB was 6.7 ± 3.5 mm in group I and 11.3 ± 3.7 mm in group II (P < 0.001). ROC curve analysis showed that 7.6 mm was the cut-off value for the anatomic risk of PE.ConclusionInfection was significantly associated with concurrent DVT and PE. The shortest length between CIA and SB (<7.6 mm) may prevent PE in patients with DVT.

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“…Pneumonia confers a major risk for VTE development with associated morbidity and mortality [33]. Current VTE prophylaxis regimens may be ineffective at preventing VTE formed under these conditions and thus an improved understanding of the underpinning molecular mechanisms is necessary [34].…”

Section: Discussionmentioning

confidence: 99%

Gram-Negative Pneumonia Alters Large-Vein Cell-Adhesion Molecule Profile and Potentiates Experimental Stasis Venous Thrombosis

Andrea

Andraska

Kanthi³

et al. 2016

J Vasc Res

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Background/Aims: Pneumonia is a significant risk factor for the development of venous thrombosis (VT). Cell-adhesion molecules (CAMs) are linked to the pathogenesis of both pneumonia and VT. We hypothesized that remote infection would confer a prothrombogenic milieu via systemic elevation of CAMs. Methods: Lung injury was induced in wild-type (C57BL/6) mice by lung contusion or intratracheal inoculation with Klebsiella pneumoniae or saline controls. K. pneumoniae-treated mice and controls additionally underwent inferior vena cava (IVC) ligation to generate VT. Results: Lung-contusion mice demonstrated no increase in E-selectin or P-selectin whereas mice infected with K. pneumoniae demonstrated increased circulating P-selectin, ICAM-1, VCAM-1 and thrombin-antithrombin (TAT) complexes. Mice with pneumonia formed VT 3 times larger than controls, demonstrated significantly more upregulation of vein-wall and systemic CAMs, and formed erythrocyte-rich thrombi. Conclusion: Elevated CAM expression was identified in mice with pneumonia, but not lung contusion, indicating that the type of inflammatory stimulus and the presence of infection drive the vein-wall response. Elevation of CAMs was associated with amplified VT and may represent an alternate mechanism by which to target the prevention of VT.

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

Abstract: The Caprini VTE risk assessment model is valid. This study supports the use of individual risk assessment in critically ill surgical patients.

Cited by 142 publications

References 38 publications

Benefits and Risks of Prophylaxis for Deep Venous Thrombosis and Pulmonary Embolus in Plastic Surgery

Benefits and Risks of Prophylaxis for Deep Venous Thrombosis and Pulmonary Embolus in Plastic Surgery

Anatomic and clinical risk factors for pulmonary embolism in patients with deep venous thrombosis of the lower extremity

Gram-Negative Pneumonia Alters Large-Vein Cell-Adhesion Molecule Profile and Potentiates Experimental Stasis Venous Thrombosis

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