Venous thromboembolism risk stratification in trauma using the Caprini risk assessment model. Issue 208 (December 2021)

• Record Type: Journal Article
• Authors: Hazeltine, Max D.; Guber, Robert D.; Buettner, Hannah; Dorfman, Jon D.
• Is Part Of: Thrombosis research. Issue 208(2021)
• Page Start: 52
• Page End: 57
• Publication Date: 2021-12
• Subjects: AIS Abbreviated Injury Scale -- aOR Adjusted odds ratio -- BMI Body mass index -- CI Confidence interval -- DVT Deep vein thrombosis -- IPC Intermittent pneumatic compression -- IQR Interquartile range -- ISS Injury Severity Score -- PE Pulmonary embolus -- RAM Risk assessment model -- RAP Risk Assessment Profile -- SD Standard deviation -- SICU Surgical intensive care unit -- TESS Trauma Embolic Scoring System -- VTE Venous thromboembolism; Venous thromboembolism -- Trauma -- Risk assessment; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2021.10.016
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Introduction: The Caprini risk assessment model is widely used for venous thromboembolism (VTE) but has limited data in trauma. The study objective was to determine if the Caprini risk assessment model could effectively risk stratify trauma patients. Materials and methods: We performed a retrospective review of trauma patients aged ≥18 years, admitted for greater than 24 h at a level one trauma center from January 1, 2018, to December 31, 2018. Demographic and clinical data were analyzed to generate Caprini scores. Multiple logistic regression assessed odds of inpatient VTE. Results: A total of 1279 patients met study eligibility, with a total of 33 VTE (2.6%). When comparing those with VTE to those without, the mean age was lower (52.5 vs 59.5, p = 0.06, respectively), sex distribution was similar, but mean body mass index was higher (30.2 vs 27.4, p = 0.019, respectively). The mean Caprini score was 9.9, and 75.5% had a score >4, the traditional Caprini high-risk cutoff. The VTE group had a higher mean Injury Severity Score (17.8 vs 12.6, p = 0.011), and mean Caprini score (16.4 vs 9.8, p < 0.001). Multiple logistic regression found Caprini score, not Injury Severity Score, was associated with higher odds of VTE (adjusted odds ratio 1.06, 95% confidence interval 1.02–1.10), after adjusting for Injury Severity Score, any missed doses of VTE chemoprophylaxis, and VTE prophylaxis type. Conclusions: Higher Caprini scores are associated with elevated odds of inpatient VTE within hospitalized trauma patients. These data support using the Caprini risk assessment model in the trauma population, which may aid in risk stratification. Highlights: Trauma patients have elevated Caprini scores compared to other patient populations. Increasing Caprini scores are associated with higher odds of venous thromboembolism. The Caprini Risk Assessment Model (RAM) can be used for risk-stratification in trauma. Risk-stratification with the Caprini RAM may aid in clinical decision making.