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Application of the Caprini Risk Assessment Model to Select Patients for Extended Thromboembolism Prophylaxis After Sleeve Gastrectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

The Caprini risk assessment model is a well-validated tool that identifies patients who would benefit from extended venous thromboembolism (VTE) prophylaxis beyond hospital discharge. VTE, particularly portal mesenteric vein thrombosis (PMVT), is a potentially devastating complication of laparoscopic sleeve gastrectomy (LSG); therefore, we sought to examine whether the model can be safely applied to LSG patients. We hypothesized that its use can minimize the incidence of postoperative VTE, including PMVT, without increasing the likelihood of bleeding complications.

Materials and Methods

We conducted a retrospective chart review of those patients who underwent LSG at our institution from 2010 and 2018, at which time the Caprini risk assessment model was already our institutional standard. We determined the patients’ Caprini scores at the time of discharge and whether patients at high risk of VTE were discharged from hospital on extended courses of VTE prophylaxis. We also recorded if bleeding complications or VTE events occurred in the first 180 days after LSG.

Results

Six hundred thirty-eight patients underwent LSG, including 521 (81.7%) women, with an average preoperative body mass index (BMI) of 44.4 kg/m2 (SD 6.8). One hundred fifty-eight (24.8%) patients had Caprini scores that warranted extended courses of VTE prophylaxis beyond hospital discharge. Three patients (0.47%) developed a postoperative VTE, but no patient developed PMVT. No bleeding complications were observed among patients who received extended VTE prophylaxis.

Conclusion

The Caprini risk assessment model can effectively identify patients after LSG who might benefit from extended courses of VTE prophylaxis. Extended VTE prophylaxis does not seem to confer increased bleeding risk in this patient population.

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Authors and Affiliations

  1. Department of Surgery, Section of Minimally Invasive Surgery, Boston Medical Center, Boston, MA, 02118, USA

    Rebecca B. Hasley, Sherif Aly, Cullen O. Carter, Brian Carmine, Donald T. Hess & Luise I. Pernar

  2. Boston University, School of Medicine, Boston, MA, 02118, USA

    Cullen O. Carter, Brian Carmine, Donald T. Hess, David McAneny & Luise I. Pernar

  3. Department of Surgery, Section of Surgical Oncology, Boston Medical Center, Boston, MA, 02118, USA

    David McAneny

Authors
  1. Rebecca B. Hasley
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  2. Sherif Aly
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  3. Cullen O. Carter
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  4. Brian Carmine
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  5. Donald T. Hess
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  6. David McAneny
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  7. Luise I. Pernar
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Correspondence to Luise I. Pernar.

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Hasley, R.B., Aly, S., Carter, C.O. et al. Application of the Caprini Risk Assessment Model to Select Patients for Extended Thromboembolism Prophylaxis After Sleeve Gastrectomy. J Gastrointest Surg 26, 298–304 (2022). https://doi.org/10.1007/s11605-021-05214-8

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  • DOI: https://doi.org/10.1007/s11605-021-05214-8

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