ABSTRACT Objective Venous thromboembolism (VTE) is a leading cause of preventable perioperative mortality in otolaryngology, highlighting the urgent need for validated risk assessments such as the Caprini score to guide prophylaxis and enhance patient safety. The objective of this study was to determine VTE outcomes following otolaryngology surgeries, stratified by Caprini scores, otolaryngological subspecialties, and socioeconomic conditions represented as Area Deprivation Index (ADI). Methods This study was conducted via a multi‐year retrospective review of 9036 otolaryngology procedures performed at multiple tertiary care hospitals within a large health system from June 2016 through December 2022. Logistic regression and multivariable models were used to investigate the relationship between VTE and Caprini score, subspecialty, and ADI. Results A total of 9036 otolaryngology surgeries were analyzed. Of those, 174 (1.9%) patients experienced a VTE and 33 (0.4%) of those patients experienced a VTE within 2 weeks after otolaryngological surgery (VTE Subset). A Caprini score of ≥ 6 resulted in a VTE (VTE: OR Unadjusted = 1.49, OR Adjusted = 1.47, p < 0.001; VTE Subset: OR Unadjusted = 1.43, OR Adjusted = 1.43, p < 0.001). In those who experienced a VTE, a Caprini score of ≥ 6 yielded a sensitivity of 0.672, specificity of 0.809, positive predictive value (PPV) of 0.065, and negative predictive value (NPV) of 0.992. In patients who experienced a VTE following otolaryngology surgery, a Caprini score of ≥ 6 showed a sensitivity of 0.727, specificity of 0.802, PPV of 0.013, and NPV of 0.999. Conclusion Caprini guidelines can function as a robust tool for ruling out VTE risk in otolaryngology surgical patients regardless of subspecialty and ADI. Level of Evidence III.
Pittman et al. (Tue,) studied this question.