The adapted Caprini score as a proxy for postoperative venous thromboembolism prophylaxis: a tertiary hospital experience

Abstract

Background: Postoperative patients’ risk for developing venous thromboembolism (VTE) can be predicted using the adapted Caprini risk assessment model which informs administration of postoperative VTE prophylaxis. The study aimed to assess the appropriateness of postoperative VTE prophylaxis of patients according to the adapted Caprini scores and investigate whether a patient’s HIV status influenced postoperative VTE prophylaxis administration.

Methods: This cohort study included patients who had elective or urgent surgery at a tertiary hospital, Bloemfontein. Data from patient files were captured on datasheets that comprised the adapted Caprini risk assessment model. The type of prophylaxis received was noted. The appropriateness of the prophylaxis prescribed was compared with the patient’s score.

Results: Details of 147 patients were included. Three of the 16 patients who did not qualify for prophylaxis, were on VTE prophylaxis on day-one post-surgery. Only 24 (18.3%) of the 131 patients who qualified for prophylaxis were on prophylaxis one day post-surgery. Of the prophylaxis prescribed, 88.5% was enoxaparin, and 11.5% "other", mainly aspirin. Twenty-three (17.6%) patients who qualified for prophylaxis were discharged on prophylaxis. Of the 147 patients, 24 patients were HIV positive, and eight of these patients received postoperative VTE prophylaxis.

Conclusion: The majority of postoperative patients at the various surgical departments of the hospital did not receive appropriate postoperative VTE prophylaxis compared to the adapted Caprini scores obtained from their medical information. A patient’s HIV status alone did not influence the decision of administering postoperative VTE prophylaxis.