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Otolaryngol Head Neck Surg. 2012 May;146(5):719-24. doi: 10.1177/0194599811434383. Epub 2012 Jan 18.

Stratifying the risk of venous thromboembolism in otolaryngology.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan 48109, USA. shumana@umich.edu

Abstract

OBJECTIVE:

The consequences of perioperative venous thromboembolism (VTE) are devastating; identifying patients at risk is an essential step in reducing morbidity and mortality. The utility of perioperative VTE risk assessment in otolaryngology is unknown. This study was designed to risk-stratify a diverse population of otolaryngology patients for VTE events.

STUDY DESIGN:

Retrospective cohort study.

SETTING:

Single-institution academic tertiary care medical center.

SUBJECTS AND METHODS:

Adult patients presenting for otolaryngologic surgery requiring hospital admission from 2003 to 2010 who did not receive VTE chemoprophylaxis were included. The Caprini risk assessment was retrospectively scored via a validated method of electronic chart abstraction. Primary study variables were Caprini risk scores and the incidence of perioperative venous thromboembolic outcomes.

RESULTS:

A total of 2016 patients were identified. The overall 30-day rate of VTE was 1.3%. The incidence of VTE in patients with a Caprini risk score of 6 or less was 0.5%. For patients with scores of 7 or 8, the incidence was 2.4%. Patients with a Caprini risk score greater than 8 had an 18.3% incidence of VTE and were significantly more likely to develop a VTE when compared to patients with a Caprini risk score less than 8 (P < .001). The mean risk score for patients with VTE (7.4) was significantly higher than the risk score for patients without VTE (4.8) (P < .001).

CONCLUSION:

The Caprini risk assessment model effectively risk-stratifies otolaryngology patients for 30-day VTE events and allows otolaryngologists to identify patient subgroups who have a higher risk of VTE in the absence of chemoprophylaxis.

PMID:
22261490
PMCID:
PMC4496153
DOI:
10.1177/0194599811434383
[Indexed for MEDLINE]
Free PMC Article

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