Hospital Venous Thromboembolism Prevention: A Year-Long Case Based Caprini Score Risk Analysis with Findings Suggesting Optimal Care.

Venous thromboembolism (VTE) is a common cause of hospital morbidity and mortality. VTE risk assessment can provide a reduction in these events if optimal prophylactic interventions are taken. The Caprini Risk Assessment (CRA) score is a validated VTE risk scoring system available for hospitalized patient risk stratification. Implementation of risk assessment in an effective and systematic way could improve prevention of VTE events. Patients were selected from a one-year retrospective chart review of adults in our hospital EMR who acquired a VTE during hospitalization. Periodic review of identified patients and determination of preventable causes of VTE were performed followed by application of the modified CRA scoring system at specific clinical event occurrences. Statistical analysis was performed via independent T-test of calculated CRA scores at the time of admission, VTE event, and discharge, comparing preventable and non-preventable groups. We identified 38 patients who acquired a VTE during hospitalization and 16 were determined to be preventable. A significant rise in CRA scores was observed from the time of admission, to the time of VTE, and at discharge. When comparing the preventable and non-preventable groups, there was no significant difference in CRA scores or trends. The CRA score is an important clinical tool that facilitates the optimal application of VTE prophylaxis. Our analysis emphasizes the importance of systematic VTE risk assessment and of improving the accuracy of the underlying clinical data. The study findings also suggest two higher risk groups that may benefit from more aggressive prophylaxis.

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