Key result
Modified Caprini score fails to accurately stratify VTE risk after lung resection.
Why the study?
There is a high incidence of venous thromboembolism (VTE) after lung resection, necessitating the identification of risk factors and evaluation of whether the modified Caprini score accurately assesses VTE risk in these patients.
What are the risk factors for VTE after lung resection, and does the modified Caprini score accurately assess this risk?
Observational (n=437)
What are the risk factors for VTE after lung resection, and does the modified Caprini score accurately assess this risk?
Absolute Event Rate: 0% vs 12.3%
p-value: p=>0.05
Age, operation duration, lymphocyte count, and D-dimer are independent risk factors for VTE after lung resection, whereas the modified Caprini score may not accurately stratify risk in this population.
Modified Caprini score failed to stratify VTE risk after lung resection; leaves open need for surgery-specific validation before clinical use.
Background: There is a high incidence of venous thromboembolism (VTE) after lung resection, so it is necessary to identify the risk factors for VTE in these patients. It is also important to evaluate whether the modified Caprini score can accurately assess the risk of VTE in patients after lung resection. Methods: This retrospective study included 437 patients undergoing lung resection between July 2016 and December 2017. All patients underwent lower extremities ultrasound before and after operation to determine the presence of the newly diagnosed VTE. Results: Forty-seven (10.8%) of the 437 patients were diagnosed with VTE after lung surgery. Multivariate logistic regression analysis showed that age (OR, 2.04; 95% CI, 1.40–2.99), duration of operation (OR, 1.51; 95% CI, 1.08–2.12), lymphocyte count (OR, 0.28; 95% CI, 0.11–0.69), and D-dimer concentration (OR, 1.55; 95% CI, 1.22–1.97) were significantly associated with VTE in lung resection patients. The cut-off values for lymphocyte count and D-dimer concentration determined using receiver operating characteristic (ROC) curve were 1.15×10 9 /L and 1.37 µg/mL respectively. The modified Caprini score divided the patients into three groups: low risk (0–4 points), moderate risk (5–8 points) and high risk (≥9 points), and the incidence of VTE was 12.3% (37/300), 7.5% (10/133) and 0% (0/4), respectively (P>0.05). Conclusions: In this study, we identified four independent factors for VTE after lung resection patients: age, duration of operation, lymphocyte count, and D-dimer. According to the modified Caprini score, there were fewer patients in the high-risk group, and the incidence of VTE not increased with the increase of risk. Better evaluation of operation time and D-dimer may help the modified Caprini score to better assess VTE risk in these patients.
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Cui et al. (2020) conducted an observational in Patients undergoing lung resection (n=437). Modified Caprini score (high risk) vs. Modified Caprini score (low risk) was evaluated on Venous thromboembolism (VTE) (p=>0.05). The modified Caprini score did not accurately stratify VTE risk after lung resection (0% in high-risk vs 12.3% in low-risk; P>0.05), though age, operation duration, lymphocytes, and D-dimer were independent risk factors.
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