Validation of the caprini risk assessment model in plastic and reconstructive surgery patients

Christopher J. Pannucci, Steven H. Bailey, George Dreszer, Christine Fisher Wachtman, Justin W. Zumsteg, Reda M. Jaber, Jennifer B. Hamill, Keith M. Hume, J. Peter Rubin, Peter C. Neligan, Loree K. Kalliainen, Ronald E. Hoxworth, Andrea L. Pusic, Edwin G. Wilkins

Research output: Contribution to journalArticle

182 Citations (Scopus)

Abstract

Background The Venous Thromboembolism Prevention Study (VTEPS) Network is a consortium of 5 tertiary referral centers established to examine venous thromboembolism (VTE) in plastic surgery patients. We report our midterm analyses of the study's control group to evaluate the incidence of VTE in patients who receive no chemoprophylaxis, and validate the Caprini Risk Assessment Model (RAM) in plastic surgery patients. Study Design Medical record review was performed at VTEPS centers for all eligible plastic surgery patients between March 2006 and June 2009. Inclusion criteria were Caprini score <3, surgery under general anesthesia, and postoperative hospital admission. Patients who received chemoprophylaxis were excluded. Dependent variables included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) within the first 60 postoperative days and time to DVT or PE. Results We identified 1,126 historic control patients. The overall VTE incidence was 1.69%. Approximately 1 in 9 (11.3%) patients with Caprini score >8 had a VTE event. Patients with Caprini score >8 were significantly more likely to develop VTE when compared with patients with Caprini score of 3 to 4 (odds ratio [OR] 20.9, p < 0.001), 5 to 6 (OR 9.9, p < 0.001), or 7 to 8 (OR 4.6, p = 0.015). Among patients with Caprini score 7 to 8 or Caprini score >8, VTE risk was not limited to the immediate postoperative period (postoperative days 1-14). In these high-risk patients, more than 50% of VTE events were diagnosed in the late (days 15-60) postoperative period. Conclusions The Caprini RAM effectively risk-stratifies plastic and reconstructive surgery patients for VTE risk. Among patients with Caprini score >8, 11.3% have a postoperative VTE when chemoprophylaxis is not provided. In higher risk patients, there was no evidence that VTE risk is limited to the immediate postoperative period.

Original languageEnglish (US)
Pages (from-to)105-112
Number of pages8
JournalJournal of the American College of Surgeons
Volume212
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Reconstructive Surgical Procedures
Venous Thromboembolism
Plastic Surgery
Postoperative Period
Chemoprevention
Tertiary Care Centers

ASJC Scopus subject areas

  • Surgery

Cite this

Pannucci, C. J., Bailey, S. H., Dreszer, G., Fisher Wachtman, C., Zumsteg, J. W., Jaber, R. M., ... Wilkins, E. G. (2011). Validation of the caprini risk assessment model in plastic and reconstructive surgery patients. Journal of the American College of Surgeons, 212(1), 105-112. https://doi.org/10.1016/j.jamcollsurg.2010.08.018

Validation of the caprini risk assessment model in plastic and reconstructive surgery patients. / Pannucci, Christopher J.; Bailey, Steven H.; Dreszer, George; Fisher Wachtman, Christine; Zumsteg, Justin W.; Jaber, Reda M.; Hamill, Jennifer B.; Hume, Keith M.; Rubin, J. Peter; Neligan, Peter C.; Kalliainen, Loree K.; Hoxworth, Ronald E.; Pusic, Andrea L.; Wilkins, Edwin G.

In: Journal of the American College of Surgeons, Vol. 212, No. 1, 01.2011, p. 105-112.

Research output: Contribution to journalArticle

Pannucci, CJ, Bailey, SH, Dreszer, G, Fisher Wachtman, C, Zumsteg, JW, Jaber, RM, Hamill, JB, Hume, KM, Rubin, JP, Neligan, PC, Kalliainen, LK, Hoxworth, RE, Pusic, AL & Wilkins, EG 2011, 'Validation of the caprini risk assessment model in plastic and reconstructive surgery patients', Journal of the American College of Surgeons, vol. 212, no. 1, pp. 105-112. https://doi.org/10.1016/j.jamcollsurg.2010.08.018
Pannucci, Christopher J. ; Bailey, Steven H. ; Dreszer, George ; Fisher Wachtman, Christine ; Zumsteg, Justin W. ; Jaber, Reda M. ; Hamill, Jennifer B. ; Hume, Keith M. ; Rubin, J. Peter ; Neligan, Peter C. ; Kalliainen, Loree K. ; Hoxworth, Ronald E. ; Pusic, Andrea L. ; Wilkins, Edwin G. / Validation of the caprini risk assessment model in plastic and reconstructive surgery patients. In: Journal of the American College of Surgeons. 2011 ; Vol. 212, No. 1. pp. 105-112.
@article{527efb7e56304ae6a76cacde20450b2f,
title = "Validation of the caprini risk assessment model in plastic and reconstructive surgery patients",
abstract = "Background The Venous Thromboembolism Prevention Study (VTEPS) Network is a consortium of 5 tertiary referral centers established to examine venous thromboembolism (VTE) in plastic surgery patients. We report our midterm analyses of the study's control group to evaluate the incidence of VTE in patients who receive no chemoprophylaxis, and validate the Caprini Risk Assessment Model (RAM) in plastic surgery patients. Study Design Medical record review was performed at VTEPS centers for all eligible plastic surgery patients between March 2006 and June 2009. Inclusion criteria were Caprini score <3, surgery under general anesthesia, and postoperative hospital admission. Patients who received chemoprophylaxis were excluded. Dependent variables included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) within the first 60 postoperative days and time to DVT or PE. Results We identified 1,126 historic control patients. The overall VTE incidence was 1.69{\%}. Approximately 1 in 9 (11.3{\%}) patients with Caprini score >8 had a VTE event. Patients with Caprini score >8 were significantly more likely to develop VTE when compared with patients with Caprini score of 3 to 4 (odds ratio [OR] 20.9, p < 0.001), 5 to 6 (OR 9.9, p < 0.001), or 7 to 8 (OR 4.6, p = 0.015). Among patients with Caprini score 7 to 8 or Caprini score >8, VTE risk was not limited to the immediate postoperative period (postoperative days 1-14). In these high-risk patients, more than 50{\%} of VTE events were diagnosed in the late (days 15-60) postoperative period. Conclusions The Caprini RAM effectively risk-stratifies plastic and reconstructive surgery patients for VTE risk. Among patients with Caprini score >8, 11.3{\%} have a postoperative VTE when chemoprophylaxis is not provided. In higher risk patients, there was no evidence that VTE risk is limited to the immediate postoperative period.",
author = "Pannucci, {Christopher J.} and Bailey, {Steven H.} and George Dreszer and {Fisher Wachtman}, Christine and Zumsteg, {Justin W.} and Jaber, {Reda M.} and Hamill, {Jennifer B.} and Hume, {Keith M.} and Rubin, {J. Peter} and Neligan, {Peter C.} and Kalliainen, {Loree K.} and Hoxworth, {Ronald E.} and Pusic, {Andrea L.} and Wilkins, {Edwin G.}",
year = "2011",
month = "1",
doi = "10.1016/j.jamcollsurg.2010.08.018",
language = "English (US)",
volume = "212",
pages = "105--112",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Validation of the caprini risk assessment model in plastic and reconstructive surgery patients

AU - Pannucci, Christopher J.

AU - Bailey, Steven H.

AU - Dreszer, George

AU - Fisher Wachtman, Christine

AU - Zumsteg, Justin W.

AU - Jaber, Reda M.

AU - Hamill, Jennifer B.

AU - Hume, Keith M.

AU - Rubin, J. Peter

AU - Neligan, Peter C.

AU - Kalliainen, Loree K.

AU - Hoxworth, Ronald E.

AU - Pusic, Andrea L.

AU - Wilkins, Edwin G.

PY - 2011/1

Y1 - 2011/1

N2 - Background The Venous Thromboembolism Prevention Study (VTEPS) Network is a consortium of 5 tertiary referral centers established to examine venous thromboembolism (VTE) in plastic surgery patients. We report our midterm analyses of the study's control group to evaluate the incidence of VTE in patients who receive no chemoprophylaxis, and validate the Caprini Risk Assessment Model (RAM) in plastic surgery patients. Study Design Medical record review was performed at VTEPS centers for all eligible plastic surgery patients between March 2006 and June 2009. Inclusion criteria were Caprini score <3, surgery under general anesthesia, and postoperative hospital admission. Patients who received chemoprophylaxis were excluded. Dependent variables included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) within the first 60 postoperative days and time to DVT or PE. Results We identified 1,126 historic control patients. The overall VTE incidence was 1.69%. Approximately 1 in 9 (11.3%) patients with Caprini score >8 had a VTE event. Patients with Caprini score >8 were significantly more likely to develop VTE when compared with patients with Caprini score of 3 to 4 (odds ratio [OR] 20.9, p < 0.001), 5 to 6 (OR 9.9, p < 0.001), or 7 to 8 (OR 4.6, p = 0.015). Among patients with Caprini score 7 to 8 or Caprini score >8, VTE risk was not limited to the immediate postoperative period (postoperative days 1-14). In these high-risk patients, more than 50% of VTE events were diagnosed in the late (days 15-60) postoperative period. Conclusions The Caprini RAM effectively risk-stratifies plastic and reconstructive surgery patients for VTE risk. Among patients with Caprini score >8, 11.3% have a postoperative VTE when chemoprophylaxis is not provided. In higher risk patients, there was no evidence that VTE risk is limited to the immediate postoperative period.

AB - Background The Venous Thromboembolism Prevention Study (VTEPS) Network is a consortium of 5 tertiary referral centers established to examine venous thromboembolism (VTE) in plastic surgery patients. We report our midterm analyses of the study's control group to evaluate the incidence of VTE in patients who receive no chemoprophylaxis, and validate the Caprini Risk Assessment Model (RAM) in plastic surgery patients. Study Design Medical record review was performed at VTEPS centers for all eligible plastic surgery patients between March 2006 and June 2009. Inclusion criteria were Caprini score <3, surgery under general anesthesia, and postoperative hospital admission. Patients who received chemoprophylaxis were excluded. Dependent variables included symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) within the first 60 postoperative days and time to DVT or PE. Results We identified 1,126 historic control patients. The overall VTE incidence was 1.69%. Approximately 1 in 9 (11.3%) patients with Caprini score >8 had a VTE event. Patients with Caprini score >8 were significantly more likely to develop VTE when compared with patients with Caprini score of 3 to 4 (odds ratio [OR] 20.9, p < 0.001), 5 to 6 (OR 9.9, p < 0.001), or 7 to 8 (OR 4.6, p = 0.015). Among patients with Caprini score 7 to 8 or Caprini score >8, VTE risk was not limited to the immediate postoperative period (postoperative days 1-14). In these high-risk patients, more than 50% of VTE events were diagnosed in the late (days 15-60) postoperative period. Conclusions The Caprini RAM effectively risk-stratifies plastic and reconstructive surgery patients for VTE risk. Among patients with Caprini score >8, 11.3% have a postoperative VTE when chemoprophylaxis is not provided. In higher risk patients, there was no evidence that VTE risk is limited to the immediate postoperative period.

UR - http://www.scopus.com/inward/record.url?scp=78650587260&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650587260&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2010.08.018

DO - 10.1016/j.jamcollsurg.2010.08.018

M3 - Article

VL - 212

SP - 105

EP - 112

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 1

ER -