Prevention of Postoperative Venous Thromboembolism in Thoracic Surgical Patients: Implementation and Evaluation of a Caprini Risk Assessment Protocol

Journal of the American College of Surgeons
Krista J HacheyVirginia R Litle

Abstract

Venous thromboembolism (VTE) can be a devastating postoperative complication, with about one-third of VTEs occurring post-discharge. We previously retrospectively evaluated the Caprini VTE risk assessment model (RAM) in postoperative lung and esophageal cancer patients, demonstrating that "high risk" patients were more likely to have a postoperative VTE. In this study, we sought to implement the RAM protocol in thoracic surgical patients to evaluate adherence, safety, and VTE outcomes. This prospective cohort study at a large safety net hospital included all surgically treated patients within the thoracic surgery division beginning in July 2014. Per RAM protocol, patients with high risk scores were prescribed a total of 30 days of postoperative daily enoxaparin prophylaxis, and moderate risk patients received a total of 10 postoperative days. Adherence and outcome audits were conducted. A total of 126 patients were included for analysis. Provider adherence to RAM score calculation was 99.2% (125 of 126), with appropriate post-discharge prophylaxis prescribed in 96.0% of cases. Twenty-four patients scored high risk (19.2%), 60 were moderate risk (48.0%), and 41 scored low risk (32.8%). Patient adherence to post-discharge enoxapa...Continue Reading

References

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Citations

May 2, 2016·The Journal of Thoracic and Cardiovascular Surgery·Virginia R Litle
Aug 1, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Yaron ShargallVirginia Litle
Nov 7, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Mason A Brown, Daniel H Fulkerson
Nov 27, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·John AgzarianYaron Shargall
Oct 12, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Timothy J P BatchelorBabu Naidu
Aug 14, 2019·World Journal of Surgery·Michelle B MulderRobert M Van Haren
Jul 14, 2018·Annals of Gastroenterological Surgery·Yoshihiro TanakaKazuya Yamaguchi
Oct 6, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Chunfeng SongBin Hu
Feb 23, 2021·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Jung In ParkAlpesh Amin
Jul 21, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Alessandro ParoTimothy M Pawlik

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