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Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women

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Abstract

Introduction and Hypothesis

The objective was to investigate the incidence and risk factors of lower extremity deep vein thrombosis (DVT) in elderly women undergoing colpocleisis for pelvic organ prolapse and to evaluate the predictive efficacy of the Caprini scores.

Methods

Data from patients who underwent colpocleisis from August 2019 to April 2024 were retrospectively analyzed. The primary endpoint was DVT detected by ultrasonography within 7 days of surgery. Univariate and multivariate logistic regression analyses were applied to identify independent risk factors. Efficacy parameters of the Caprini scores were analyzed and optimal cut-off values were selected.

Results

A total of 262 patients were enrolled in the study, of whom 8.4% (22 out of 262) developed DVT postoperatively. After statistical analysis, the duration of menopause, history of inflammatory bowel disease, as well as higher levels of preoperative cholesterol and preoperative D-dimer, were identified as independent risk factors. There was a significant difference in the Caprini scores between the DVT and non-DVT groups (7.27 ± 1.28 vs 6.15 ± 0.80, p < 0.001), and the risk of DVT tended to increase with higher Caprini scores. The best performance was achieved when the threshold for the Caprini score was set to 7, at which point the area under the receiver operating characteristic curve was 0.758, the sensitivity was 0.773, and the specificity was 0.662.

Conclusion

There was a strong correlation between the occurrence of DVT after colpocleisis and the Caprini score, with higher Caprini scores indicating a higher risk of postoperative DVT. A significantly increased risk was suggested when this score was ≥ 7.

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Data Availability

The data of this study are available from the corresponding author upon reasonable request.

References

  1. Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. Lancet. 2012;379:1835–46. https://doi.org/10.1016/S0140-6736(11)61904-1.

    Article  PubMed  Google Scholar 

  2. Hawkins D. Pharmacoeconomics of thrombosis management. Pharmacotherapy. 2004;24:95S–9S. https://doi.org/10.1592/phco.24.10.95S.36123.

    Article  PubMed  Google Scholar 

  3. Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008;28:370–2. https://doi.org/10.1161/ATVBAHA.108.162545.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. 2004;126:338S–400S. https://doi.org/10.1378/chest.126.3_suppl.338S.

    Article  PubMed  Google Scholar 

  5. Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, Samama CM. Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e227S–77S. https://doi.org/10.1378/chest.11-2297.

    Article  PubMed  PubMed Central  Google Scholar 

  6. American College of Obstetricians and Gynecologists. Prevention of venous thromboembolism in gynecologic surgery: ACOG practice bulletin, number 232. Obstet Gynecol. 2021;138:e1–15. https://doi.org/10.1097/AOG.0000000000004445.

    Article  Google Scholar 

  7. Jorgensen EM, Li A, Modest AM, Leung K, Moore Simas TA, Hur HC. Incidence of venous thromboembolism after different modes of gynecologic surgery. Obstet Gynecol. 2018;132:1275–84. https://doi.org/10.1097/AOG.0000000000002918.

    Article  PubMed  Google Scholar 

  8. Lee WS, Kim KI, Lee HJ, Kyung HS, Seo SS. The incidence of pulmonary embolism and deep vein thrombosis after knee arthroplasty in Asians remains low: a meta-analysis. Clin Orthop Relat Res. 2013;471:1523–32. https://doi.org/10.1007/s11999-012-2758-9.

    Article  PubMed  Google Scholar 

  9. Persson LM, Lapidus LJ, Lärfars G, Rosfors S. Asymptomatic deep venous thrombosis is associated with a low risk of post-thrombotic syndrome. Eur J Vasc Endovasc Surg. 2009;38:229–33. https://doi.org/10.1016/j.ejvs.2008.03.021.

    Article  PubMed  Google Scholar 

  10. Obi AT, Pannucci CJ, Nackashi A, Abdullah N, Alvarez R, Bahl V, et al. Validation of the Caprini venous thromboembolism risk assessment model in critically ill surgical patients. JAMA Surg. 2015;150:941–8. https://doi.org/10.1001/jamasurg.2015.1841.

    Article  PubMed  Google Scholar 

  11. Hayssen H, Cires-Drouet R, Englum B, Nguyen P, Sahoo S, Mayorga-Carlin M, et al. Systematic review of venous thromboembolism risk categories derived from Caprini score. J Vasc Surg Venous Lymphat Disord. 2022;10:1401–9.e7. https://doi.org/10.1016/j.jvsv.2022.05.003.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Krauss ES, Segal A, Cronin MA, Dengler N, Lesser ML, Ahn S, Caprini JA. Implementation and validation of the 2013 Caprini score for risk stratification of arthroplasty patients in the prevention of venous thrombosis. Clin Appl Thromb Hemost. 2019;25:1076029619838066. https://doi.org/10.1177/1076029619838066.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27:655–84. https://doi.org/10.1007/s00192-016-3003-y.

    Article  PubMed  Google Scholar 

  14. Raju R, Occhino JA, Linder BJ. LeFort partial colpocleisis: tips and technique. Int Urogynecol J. 2020;31:1697–9. https://doi.org/10.1007/s00192-019-04194-3.

    Article  PubMed  Google Scholar 

  15. Wang Q, Lin H, Wu N, Li Y, Zhao R, Xu Y, Lin C. Outcomes of a novel modified total colpocleisis for advanced pelvic organ prolapse in elderly women and its efficacy on lower urinary tract symptoms. Int J Gynecol Obstet. 2024;164:1132–40. https://doi.org/10.1002/ijgo.15161.

    Article  Google Scholar 

  16. Schellong SM, Encke A, Weber AA, Bramlage P, Paar WD, Haas S. Benefits and risks of preventing thromboembolism with enoxaparin in patients with general surgery in real world—The CLEVER Study. Clin Appl Thromb Hemost. 2013;19:282–8. https://doi.org/10.1177/1076029612461067.

    Article  PubMed  Google Scholar 

  17. High R, Kavanagh A, Khavari R, Stewart J, Antosh DD. Outcomes in pelvic organ prolapse surgery in women using chronic antithrombotic therapy. Urogynecology. 2017;23:372–6. https://doi.org/10.1097/SPV.0000000000000405.

    Article  Google Scholar 

  18. Chong W, Bui AH, Menhaji K. Incidence and risk factors for venous thromboembolism events after different routes of pelvic organ prolapse repairs. Am J Obstet Gynecol. 2020;223:268.e1–26. https://doi.org/10.1016/j.ajog.2020.05.020.

    Article  PubMed  Google Scholar 

  19. Mueller MG, Pilecki MA, Catanzarite T, Jain U, Kim JY, Kenton K. Venous thromboembolism in reconstructive pelvic surgery. Am J Obstet Gynecol. 2014;211:552.e1–6. https://doi.org/10.1016/j.ajog.2014.07.031.

    Article  PubMed  Google Scholar 

  20. Hokenstad ED, Habermann EB, Glasgow AE, Occhino JA. Risk of venous thromboembolism in patients undergoing surgery for pelvic organ prolapse. Int Urogynecol J. 2016;27:1525–8. https://doi.org/10.1007/s00192-016-2990-z.

    Article  PubMed  Google Scholar 

  21. Hill AJ, Walters MD, Unger CA. Perioperative adverse events associated with colpocleisis for uterovaginal and posthysterectomy vaginal vault prolapse. Am J Obstet Gynecol. 2016;214:501.e1–6. https://doi.org/10.1016/j.ajog.2015.10.921.

    Article  PubMed  Google Scholar 

  22. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70–8. https://doi.org/10.1016/j.disamonth.2005.02.003.

    Article  PubMed  Google Scholar 

  23. Qu H, Li Z, Zhai Z, Liu C, Wang S, Guo S, Zhang Z. Predicting of venous thromboembolism for patients undergoing gynecological surgery. Medicine (Baltimore). 2015;94:e1653. https://doi.org/10.1097/MD.0000000000001653.

    Article  PubMed  Google Scholar 

  24. Qiao L, Yao Y, Wu D, Xu R, Cai H, Shen Y, Xu Z, Jiang Q. The validation and modification of the Caprini risk assessment model for evaluating venous thromboembolism after joint arthroplasty. Thromb Haemost. 2024;124:223–35. https://doi.org/10.1055/a-2174-0963.

    Article  PubMed  Google Scholar 

  25. Jiang XX, Li XY, Zhang J, Wang XX, Lin CQ. A nomogram model can predict the risk of venous thromboembolism in postoperative patients with gynecological malignancies. Int J Gynecol Obstet. 2022;158:689–99. https://doi.org/10.1002/ijgo.14061.

    Article  Google Scholar 

  26. Heft J, Goulder A, Schneiter M, Adam R. Venous thromboembolism prediction in postoperative urogynecology patients: the utility of risk assessment tools. Urogynecology. 2020;26:e27–32. https://doi.org/10.1097/SPV.0000000000000780.

    Article  Google Scholar 

  27. Lobastov K, Urbanek T, Stepanov E, Lal BK, Marangoni J, Krauss ES, et al. The thresholds of Caprini score associated with increased risk of venous thromboembolism across different specialties: a systematic review. Ann Surg. 2023;277:929–37. https://doi.org/10.1097/SLA.0000000000005843.

    Article  PubMed  Google Scholar 

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Funding

This study was funded by the Startup Fund for scientific research, Fujian Medical University (Grant number: 2023QH1184).

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Author notes

  1. Qi Wang and Xiaoxiang Jiang contributed equally to this work

Authors and Affiliations

  1. Department of Gynecology, Fujian Maternity and Child Health Hospital, 18 Dao-shan street, Gu-lou District, Fuzhou, PR China

    Qi Wang, Xiaoxiang Jiang & Chaoqin Lin

  2. College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, PR China

    Qi Wang, Xiaoxiang Jiang & Chaoqin Lin

  3. Fujian Provincial Key Laboratory of Women and Children’s Critical Diseases Research, Fuzhou, PR China

    Qi Wang, Xiaoxiang Jiang & Chaoqin Lin

Authors
  1. Qi Wang
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  2. Xiaoxiang Jiang
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Contributions

Q. Wang: project development, data collection, manuscript writing; X. Jiang: project development, data management, manuscript writing; C. Lin: project administration, manuscript review, and revision.

Corresponding author

Correspondence to Chaoqin Lin.

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Ethical approval was granted by the Ethical Review Committee of Fujian Maternity and Child Health Hospital (2024KY105).

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Wang, Q., Jiang, X. & Lin, C. Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05937-7

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