title: Validation of a venous thromboembolism risk assessment model in gynecologic oncology.
abstract: OBJECTIVE
  Gynecologic oncology patients undergoing surgery are at an increased risk for venous thromboembolism (VTE). We attempted to validate a VTE risk assessment model in gynecologic oncology patients.
  
  
  METHODS
  All gynecologic oncology patients who underwent a laparotomy for the diagnosis or suspicion of gynecologic malignancy from 2004 to 2010 were included. Demographic, surgicopathologic, and complication data were collected. VTE was based on the symptomatic diagnosis. Data for the Caprini risk assessment model (RAM) was used to score and stratify patients on their risk for VTE.
  
  
  RESULTS
  1123 gynecologic oncology patients were included within this study. Ovarian cancer was the most common diagnosis (39%) with a median age of 56.1. All patients received SCDs with 40% receiving double prophylaxis. The overall incidence of VTE was 3.3%, with lower extremity deep venous thrombosis (DVT) n=17 and pulmonary embolism (PE) n=20. Complication rates were similar in each group. Based on the Caprini scoring model 92% of patients scored in the "Highest Risk" category. The Caprini RAM accurately predicted all 37 VTEs, all of which scored in the "Highest Risk" category. The percentage of patients that received double prophylaxis increased with time from 12% in 2004 to 63% in 2010. Importantly, 25 of the 37 VTEs (68%) did not receive double prophylaxis.
  
  
  CONCLUSIONS
  The use of the Caprini RAM accurately predicted patients at the highest risk of experiencing VTE. Considering accurate identification of patients allows proper administration of double prophylaxis, we recommend the use of this scoring model preoperatively in patients undergoing surgery for gynecologic malignancies.
authors.affiliation: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Stroud
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Whitworth
authors.affiliation: Ochsner Health System, New Orleans, LA, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Miklic
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Kellie E
authors.initials: KE
authors.lastname: Schneider
authors.affiliation: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Finan
authors.affiliation: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scalici
authors.affiliation: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA.
authors.forename: Eddie
authors.initials: E
authors.lastname: Reed
authors.affiliation: Ochsner Health System, New Orleans, LA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bazzett-Matabele
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
authors.affiliation: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA. Electronic address: rocconi@health.southalabama.edu.
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Rocconi
mesh_terms: D000328:Adult; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008875:Middle Aged; D015233:Models, Statistical; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control*
keywords: Caprini; Deep venous thrombosis; Gynecologic oncology; Prophylaxis; Pulmonary embolism; Venous thromboembolism