Assessing the risk for development of Venous Thromboembolism (VTE) in surgical patients using Adapted Caprini scoring system.
OBJECTIVE
To determine the incidence, morbidity and mortality due to Venous Thromboembolism (VTE) in surgical patients, and to assess the validity and reliability of Adapted Caprini scoring in risk stratification for VTE prophylaxis.


METHODS
This was a prospective observational study in a tertiary care hospital of South India on patients who underwent both elective and emergency surgeries over a period of 9 months. An Adapted Caprini score was devised which included only the clinical criteria. The patients were scored by two persons independently at admission and followed up till the 30th post-operative day and primary and secondary end points were statistically analyzed.


RESULTS
Three hundred and one patients were included and the overall incidence of VTE at 30 days was 7.3%. The risk of developing VTE was found to be significantly higher among the >8 score group as compared to 3-4 group (OR = 153.5, p < 0.001), or the 5-6 group (OR = 52.9, p < 0.001) or the 7-8 group (OR = 2.3, p = 0.002). Patients with a score of 7-8 were more likely to develop VTE as compared to 3-4 group (OR = 67.5, p < 0.001) or the 5-6 group (OR = 23.2, p < 0.001).


CONCLUSIONS
The risk of developing VTE is less significant in the 5-6 score group compared to 7-8 or more score group. Further stratification of the highest risk groups is recommended to provide appropriate prophylaxis only to the patients with high scores, thereby reducing complications due to VTE prophylaxis.
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Kanchan
K
Bilgi
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Anitha
A
Muthusamy
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Mohsina
M
Subair
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Sanjeev
S
Srinivasan
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Arun
A
Kumar
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Ramya
R
Ravi
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Ranjith
R
Kumar
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Sathasivam
S
Sureshkumar
Department of Social and Preventive Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
T
T
Mahalakshmy
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India.
Pankaj
P
Kundra
Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, 605006, India. Electronic address: drvikramkate@gmail.com.
Vikram
V
Kate
D000328:Adult; D000368:Aged; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology*
Deep venous thrombosis; Pulmonary embolism; Risk assessment model; Risk stratification; Thromboembolism prophylaxis