876 To Score or Not to Score - Is Caprini the Best Tool for Post-Operative VTE Risk Stratification in Patients Undergoing Thoracic Surgery?

Aim The incidence of venous thromboembolism (VTE) is high post thoracic surgery, particularly following lung resection. However, there is no consensus to effectively identify and prevent post-op VTE. The modified Caprini score is already used by many surgical specialties, but not all UK Thoracic centres utilise this tool as part of pre-operative assessment. Our centre has implemented the Caprini score since April 2019. Method This retrospective single-centre study evaluated patients who underwent thoracic surgery in 2020 and had a diagnosis of VTE at any point post-surgery. Patients were included if they underwent thoracic surgery regardless of pathology or procedure, had a documented Caprini score during pre-operative assessment, and, radiologically confirmed diagnosis of VTE irrespective of imaging modality. Results Thirteen patients from a total of 664 thoracic surgery admissions in 2020 were diagnosed with post-op VTE within 3 years. No patient developed VTE within 30 days post-surgery. The shortest period from operation date to VTE diagnosis was 86 days and longest was 1057 days. Seven patients were prescribed Enoxaparin post-discharge and six were not. Of these six patients, three were already on pre-operative anticoagulation therapy for pre-existing co-morbidities. Conclusions The Caprini is a useful risk stratification tool in patients undergoing thoracic surgery to prevent VTE within 30 days post-surgery. However, more research is required to analyse specific risk factors and procedure performed to quantify the likelihood of post-op VTE in high-risk patients. This scoring system could then be expanded and implemented within the community based on the timescales of VTE diagnosis in our study.