Validation of the Caprini Score in Trauma Patients
Robert D. Guber BS1, Max D. Hazeltine MD2, Hannah Buettner MD2, Jon D. Dorfman MD3
1University of Massachusetts Medical School, Worcester, MA 2University of Massachusetts Medical School, Department of Surgery, Worcester, MA 3University of Massachusetts Medical School, Department of Surgery, Division of Trauma and Surgical Critical Care, Worcester, MA
Background: Admitted trauma patients are at high risk for venous thromboembolism (VTE). The Caprini score is widely used and validated in general surgery and surgical critical care patients but not in the trauma surgery population where a diagnosis of polytrauma or hip fracture alone places patients in the Caprini high risk category.
Methods: We performed a retrospective review of adult trauma patients admitted for >24 hours at a Level 1 trauma center from January 1, 2018 to September 6, 2018. We analyzed demographic and clinical data to generate Caprini scores.
Results: To date, we have included 750 admitted trauma patients. The mean age was 59.2 years (IQR 39-79), 62% were male with a mean BMI of 27. The mean Injury Severity Score (ISS) was 12.3 (IQR 8-17). The mean Caprini score was 8.1 (IQR 4-11), with 71% scoring >4. The most common 5-point Caprini risk factors were polytrauma (47%) and pelvis/leg fracture (21%). Nine deep venous thromboses and 10 pulmonary emboli occurred in 18 patients (2.4%). Logistic regression analysis found that ISS was not associated with VTE (OR 1.04, p=0.13), but Caprini score was (OR 1.11, p=0.01).
Conclusion: We demonstrate that trauma patients with higher Caprini scores have significantly higher odds of in hospital VTE. However, ISS was found to not have a significant relationship with odds of VTE.
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