| Objective: Venous thromboembolism(VTE),including pulmonary embolism(PE)and deep vein thrombosis(DVT),is one of the most important causes of death in perioperative patients.Effective preventive measures can significantly reduce the incidence of VTE.Among risk assessment models,Caprini risk assessment model is one of the most widely used models.This study retrospectively analyzed the effect of Caprini model on preventing the risk of VTE in perioperative inpatients.Methods:The clinical data of all perioperative patients admitted to Shengjing Hospital Affiliated to China Medical University from November 2021 to October 2022 in the Department of General Surgery,Department of orthopedics,Department of Urology,Department of Gynecology and Department of Obstetrics were included.The case group and control group were selected according to whether DVT and/or PE were diagnosed.Propensity score matching(PSM)was used to set the caliper value as 0.01.The matched case groups and control groups were selected based on age,gender,length of stay,major discharge diagnosis,and major operation level of patients in a 1:3 ratio using the nearest neighbor matching.The application rate of Caprini model,VTE risk stratification(low risk: 0-1 score,moderate risk :2 score,high risk: 3-4 score,or very high risk ≥5 score),the implementation rate of VTE prevention and the incidence of VTE after implementation were compared between the case group and the control group.SPSS26.0 was used for statistical analysis,and P < 0.05 showed statistical difference.Results:1.PSM successfully matched 139 cases in the case group and 417 cases in the control group.The unbalanced covariates of the two groups reached P > 0.05 after matching,and the equilibrium of each covariates was improved.2.After PSM,the proportion of patients with Caprini score is 43.88% in case group and49.40% in control group,and there is no statistical significance between the two groups(P > 0.05).These results suggest that a certain percentage of patients in case group and control group have not been evaluated for VTE risk assessment in perioperative period.3.Among patients in case group and control group who complete Caprini score,low risk,moderate risk,high risk and very high risk are compared as risk stratifications,and the results show no statistical significance between the two groups(P > 0.05).From the perspective of distribution trend,very high risk patients account for the highest proportion in both groups,followed by high risk patients.The sum ratio of the two groups in the case group and the control group reaches 72.13% and 69.42%,respectively,indicating that Caprini model may be used more frequently in patients who are predicted to be at risk for perioperative venous thrombosis.4.After PSM,the proportion of patients who complete Caprini score and receive preventive anticoagulant therapy based on Caprini score results in case group and control group is 22.95% and 44.66%,respectively,showing statistical difference between the two groups(P<0.05).This result suggests that Caprini score can be used to evaluate the risk of VTE and provide corresponding anticoagulation measures,which has a certain role in preventing the occurrence of VTE in perioperative patients.Conclusion: In clinical practice,there is still a significant proportion of patients who do not receive perioperative VTE risk assessment,or do not take targeted VTE preventive measures after assessment,and there is still a certain gap between recommended VTE preventive measures and actual implementation of VTE preventive measures,which should arouse clinicians’ attention.Caprini risk assessment model plays a certain role in the early warning and prevention of VTE in perioperative patients,but its content still needs to be further improved. |
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