Risk factors for post-operative VTE following colorectal surgery: Is caprini score enough?

Caprini score Colorectal surgery Risk factors Venous thromboembolism

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 Mar 2024
Historique:
received: 30 11 2023
revised: 15 02 2024
accepted: 27 02 2024
medline: 11 3 2024
pubmed: 11 3 2024
entrez: 10 3 2024
Statut: aheadofprint

Résumé

Post-operative colorectal venous thromboembolism (VTE) rates range between 1 and 3%. Often, surgeons utilize risk assessment models, like the modified Caprini, to determine need for prophylaxis. However, studies reveal additional unaccounted risk factors like preoperative serum albumin level, perioperative blood transfusion, emergency surgery, and preoperative steroid use. This was a multicenter, retrospective study conducted between January 2021-December 2021. The primary endpoint was to assess the VTE rate within 30 days post-operatively. Overall, incidence rate was 1.75%. Of these, 53% underwent urgent/emergent surgery and 60% had perioperative blood transfusions. Twelve patients had a known preoperative serum albumin level, with 66% being less than 3.5 ​g/dL. Only 30% of patients had a high Caprini risk score. No patient had preoperative steroid use. The study suggests considering urgent/emergent surgeries, low preoperative albumin levels, and blood transfusions for enhanced VTE screening and prophylaxis in post-operative colorectal patients.

Sections du résumé

BACKGROUND BACKGROUND
Post-operative colorectal venous thromboembolism (VTE) rates range between 1 and 3%. Often, surgeons utilize risk assessment models, like the modified Caprini, to determine need for prophylaxis. However, studies reveal additional unaccounted risk factors like preoperative serum albumin level, perioperative blood transfusion, emergency surgery, and preoperative steroid use.
METHODS METHODS
This was a multicenter, retrospective study conducted between January 2021-December 2021. The primary endpoint was to assess the VTE rate within 30 days post-operatively.
RESULTS RESULTS
Overall, incidence rate was 1.75%. Of these, 53% underwent urgent/emergent surgery and 60% had perioperative blood transfusions. Twelve patients had a known preoperative serum albumin level, with 66% being less than 3.5 ​g/dL. Only 30% of patients had a high Caprini risk score. No patient had preoperative steroid use.
CONCLUSION CONCLUSIONS
The study suggests considering urgent/emergent surgeries, low preoperative albumin levels, and blood transfusions for enhanced VTE screening and prophylaxis in post-operative colorectal patients.

Identifiants

pubmed: 38462412
pii: S0002-9610(24)00158-2
doi: 10.1016/j.amjsurg.2024.02.046
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have no conflict of interest regarding this study. No off label or unapproved drugs were utilized. Prior copyrighted material was also not utilized.

Auteurs

Anyelin Almanzar (A)

Department of Colorectal Surgery, Medstar Washington Hospital Center, USA. Electronic address: Anyelin_almanzar@hotmail.com.

Sophia L Dahmani (SL)

School of Medicine, Georgetown University, USA.

Sami Shoucair (S)

Department of General Surgery, Medstar Franklin Square Medical Center, USA.

Zhifei Sun (Z)

Department of Colorectal Surgery, Medstar Washington Hospital Center, USA.

Jennifer Ayscue (J)

Department of Colorectal Surgery, Orlando Health Regional Medical Center, USA.

Brian Bello (B)

Department of Colorectal Surgery, Medstar Washington Hospital Center, USA.

Sara Berkey (S)

Department of Colorectal Surgery, Medstar Washington Hospital Center, USA.

Classifications MeSH