Your patient's answers to those questions will give you an overall "Caprini score," which you can use on the day of surgery to stratify each patient's risk of DVT and, subsequently, what measures of prophylaxis you should provide. It's not reasonable to expect patients to know off the top of their head if their BMI is over 25, if they've had past obstetrical complications or if they had a venous thromboembolism (VTE) in the past but thought it not important - perhaps because it was caused by oral contraceptives that they're no longer taking. There's a risk that patients will miss a question or answer it incorrectly because they haven't had the time to fully look it over.
Don't try to give the assessment the day of surgery. That means sitting down with family members to ask about any family history of thrombosis, which is the most commonly missed question and, along with your patient's personal history of thrombosis, is one of the biggest causes of DVT. The higher the Caprini score, the greater the risk of DVT.Īsk patients to compute their Caprini score 1-2 weeks before their procedure and instruct them to take their time filling out each question. The Caprini Risk Assessment includes 20 variables and is derived from a prospective study of 538 general surgery patients. My colleagues and I created a point-based scoring model to help facilities determine which surgical patients are most at risk of developing DVT andĮxactly what in their medical history leads them to be particularly vulnerable. Once you have that information, you can decide on what prophylaxis - mechanical or anticoagulant or both - to administer and what precautions to take during surgery to cut down on the risk. It's also a largely preventable complication, as long as you identify which patients are most likely to develop it ahead of time. The good news is that DVT is completely treatable if caught in time. PE claims the lives of up to 300,000 Americans every year. This is called a pulmonary embolism, or PE, and it can be fatal. Of course, blood clots can break off and travel to another part of the body, such as the lungs. And when there are telltale signs of DVT, like shortness of breath, lung pain and chest pain, they often don't show up in patients until after you've discharged them. It's impossible to detect DVT about half of the time because there are no symptoms when a blood clot forms inside a vein, deep within the body very often in the thigh or lower leg.
Of all surgery's risks, developing blood clots of deep vein thrombosis (DVT) is one of the most dangerous - and one of the deadliest.
FATAL RISK When blood clots break off and travel to another part of the body, such as the lungs, it's called a pulmonary embolism - and it can be fatal.
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