Stratification of venous thromboembolism risk in burn patients by Caprini score.

Abstract

BACKGROUND:

The purpose of the research was to determine the efficacy of the Caprini risk assessment model for the guidance of prophylactic treatments for a 3-year period in the burn center of the Inner Mongolia region.

METHODS:

From July 2014 to August 2017, the Caprini score for every admitted patient was calculated to evaluate venous thromboembolism (VTE) risk. Subjects with a Caprini score between 0 and 2 were not administered a chemical VTE prophylaxis, and subjects with a score of 3 and above were administered low-molecular-weight heparin (LMWH). Demographic information, abbreviated burn severity index (ABSI) score, body mass index (BMI), Caprini score, full-thickness total body surface area (TBSA), overall TBSA, day of ambulation, hospital stay, inhalation injury, electrical burn, central venous catheters, and operations were noted for analysis.

RESULTS:

Of 1939 inpatients during the study period, 13 patients (0.67%) had VTE complications. The interval from injury to VTE diagnosis was 13.9±8.7 days. Among patients (n=1131) with a Caprini score between 0 and 2, two patients (0.18%) had VTE. A total of 792 patients received LMWH thromboprophylaxis; 11 patients had VTE complications, and among them, one patient (0.13%) developed heparin-induced thrombocytopenia and two patients (0.25%) developed major bleeding. VTE (8.82%) occurred most commonly in the Caprini score >8 group. Age, Caprini score, ABSI score, overall and full-thickness TBSA, central venous catheters, day of ambulation, and hospital stay in patients with VTE (n=11) were significantly higher than those (n=781) without VTE (p<0.05).

CONCLUSIONS:

Caprini score allows for informed decision-making regarding prophylaxis strategies. Early ambulation and mechanical prophylaxis are recommended for patients predisposed to VTE.

• Authors: Quan Li, Te Ba, Ling-Feng Wang, Qiang Chen, Fang Li, Yuan Xue
• Journal: Burns : journal of the International Society for Burn Injuries (Burns) Vol. 45 Issue 1 Pg. 140-145 (02 2019) ISSN: 1879-1409 [Electronic] Netherlands
• PMID: 30253959 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Chemical References

• Anticoagulants
• Heparin, Low-Molecular-Weight

Topics

• Adult
• Aged
• Anticoagulants (therapeutic use)
• Body Surface Area
• Burns (epidemiology)
• Central Venous Catheters
• China (epidemiology)
• Early Ambulation
• Female
• Heparin, Low-Molecular-Weight (therapeutic use)
• Humans
• Intermittent Pneumatic Compression Devices
• Length of Stay
• Male
• Middle Aged
• Pulmonary Embolism (epidemiology, prevention & control)
• Risk Assessment
• Risk Factors
• Trauma Severity Indices
• Venous Thromboembolism (epidemiology, prevention & control)
• Venous Thrombosis (epidemiology, prevention & control)
• Walking