Key result
Caprini Risk Score accurately predicts postoperative VTE after emergency surgery with ~0.82 AUC.
Why the study?
The validity of the Caprini Risk Score for predicting postoperative venous thromboembolism in emergency surgery and the impact of prophylactic protocol compliance on thrombosis risk were uncertain.
Does the Caprini Risk Score accurately predict postoperative venous thromboembolism in patients undergoing emergency surgery?
Cohort (n=267)
No
Does the Caprini Risk Score accurately predict postoperative venous thromboembolism in patients undergoing emergency surgery?
Effect estimate: AUC 0.82 (95% CI 0.76-0.89)
Absolute Event Rate: 55.6% vs 2.3%
p-value: p=<0.001
The Caprini Risk Score is a valid tool for predicting postoperative venous thromboembolism in emergency surgery, where patients with a score ≥5 are at higher risk of complications.
May support Caprini score for VTE stratification in emergency surgery; extends validation but leaves open prospective confirmation.
Objective. To evaluate validity of the Caprini Risk Score (CRS) for predicting postoperative venous thromboembolism (VTE) in emergency surgery, as well as to investigate the impact of compliance with prophylactic protocols on the risk of postoperative thrombosis. Material and methods. A single-center prospective study included 267 patients after urgent or emergency major surgery. CRS scores were calculated before the intervention and at discharge. Routine mechanical and pharmacological prophylaxis for VTE was used after surgery. The primary endpoint was combination of asymptomatic and symptomatic deep vein thrombosis (DVT), identified with obligatory Doppler ultrasound before discharge, and pulmonary embolism (PE) verified by imaging or autopsy. Results. The incidence of postoperative VTE was 15.7% (95% CI, 11.8—20.6%), including two cases of PE (1 death). The number of VTE significantly correlated with final CRS score and increased from 2.3% in low-risk group to 55.6% in extremely high-risk group (V=0.509, p<0.001). CRS demonstrated high predictive ability: AUC=0.82 (95% CI, 0.76—0.89, p<0.001). The threshold was 5.5 scores with 81% sensitivity and 72% specificity. Compliance with the recommended anticoagulant dose was observed in 66% of patients. About 10% of patients received complete pharmacological and mechanical prophylaxis that did not affect the risk of postoperative VTE. In selective assessment, all patients with DVT had missed doses of heparins. Conclusion. The incidence of postoperative VTE in emergency surgery was 15.7% that correlated with CRS scores. Patients with CRS score ≥5 had a higher risk of complications.
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Krylov et al. (2026) conducted a cohort in Postoperative venous thromboembolism in emergency surgery (n=267). Caprini Risk Score (CRS) vs. Low-risk Caprini Risk Score was evaluated on Combination of asymptomatic and symptomatic deep vein thrombosis (DVT), identified with obligatory Doppler ultrasound before discharge, and pulmonary embolism (PE) verified by imaging or autopsy (AUC 0.82, 95% CI 0.76-0.89, p=<0.001). The Caprini Risk Score demonstrated high predictive ability for postoperative venous thromboembolism following emergency surgery (AUC 0.82; 95% CI 0.76-0.89; p<0.001).
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