Abstract
Venous thrombo-embolism (VTE) encompasses two inter-related conditions, i.e., pulmonary embolism (PE) and deep venous thrombosis (DVT). Major surgery is considered one of the important risk factors for VTE. Hence, the prediction of VTE in the pre-operative period becomes imperative for the institution of thrombo-prophylaxis. Though the Caprini score is a widely accepted and comprehensive risk prediction tool for VTE, its calculation is cumbersome due to a large number of variables. In comparison, the Padua score has lesser variables and is easy to calculate, but its effectiveness in surgical patients has not been validated till date. The aim of this study was to study the efficacy of the Padua score in the prediction of post-op VTE in surgical patients and compare the results with the Caprini score. This was a prospective, observational study conducted over 300 patients, who underwent major surgery, between Oct 2018 and Mar 2020 at a tertiary care hospital. Caprini and Padua scores were calculated for all of them in the pre-op period and results were compared. Thirty-one (10.33%) out of 300 patients developed DVT in the post-operative period. Twenty-six (15.48%) out of 168 patients developed DVT, despite thrombo-prophylaxis. On the other hand, only five (3.79%) patients developed DVT among 132 patients, who did not receive thrombo-prophylaxis. After adjusting for thrombo-prophylaxis, both Caprini and Padua scores had significant discriminatory power to predict DVT, but when compared individually, the Caprini score was a better predictor of DVT (R2 = 38.37%) than the Padua score (R2 = 31.09%). Padua score can be independently applied as a risk assessment tool for the prediction of VTE and institution of thrombo-prophylaxis in surgical patients.
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(a) Conceptualization: Dr. Vembu Anand, Dr. Dileep Ramakrishnan, Dr. Rakesh Kumar Jha.
(b) Design: Dr. Dileep Ramakrishna, Dr. Rakesh Kumar Jha, Dr. R Shankaran
(c) Definition of intellectual content: Dr. Dileep Ramakrishnan, Dr. Vembu Anand, Dr. Rakesh Kumar Jha, Dr. Surjeet Dwivedi
(d) Literature search: Dr. Rakesh Kumar Jha, Dr. Dileep Ramakrishnan, Dr. Aabhas Mishra, Dr. R Shankaran
(e) Clinical studies: Dr. Vembu Anand, Dr. Dileep Ramakrishnan, Dr. Rakesh Jha, Dr. R Shankaran, Dr. Aabhas Mishra
(f) Experimental studies: Dr. Rakesh Kumar Jha, Dr. Dileep Ramakrishnan, Dr. Surjeet Dwivedi
(g) Data acquisition, data analysis & statistical analysis: Dr. Dileep Ramakrishnan, Dr. Rakesh Kumar Jha, Dr. R. Shankaran, Dr. Aabhas Mishra, Dr. Surjeet Dwivedi
(h) Manuscript preparation: Dr. Dileep Ramakrishnan, Dr. Rakesh Kumar Jha, Dr. Aabhas Mishra
(i) Manuscript editing and manuscript review: Dr. Vembu Anand, Dr. R Shankaran, Dr. Surjeet Dwivedi
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Anand, V., Ramakrishnan, D., Jha, R.K. et al. Comparison of Caprini’s and Padua’s Risk Assessment Scores in the Prediction of Deep Vein Thrombosis in Surgical Patients at a Tertiary Care Hospital. Indian J Surg 85 (Suppl 1), 141–146 (2023). https://doi.org/10.1007/s12262-022-03405-4
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DOI: https://doi.org/10.1007/s12262-022-03405-4