Clinical

Caprini score is not a good predictor of PE in patients with DVT

 

Key clinical point: The Caprini model shows a poor association with PE or hemodynamically significant PE in patients with DVT.

Major finding: Among 838 patients presenting with DVT, nearly 26% had concomitant PE, more than half of which was hemodynamically significant.

Data source: A single-center, retrospective review of 838 patients diagnosed with DVT.

Disclosures: The authors reported that they had no conflicts of interest.


 

FROM THE JOURNAL OF VASCULAR SURGERY: VENOUS AND LYMPHATIC DISORDERS

 

The Caprini score, commonly used to risk stratify patients for the development of venous thromboembolism and to determine the optimal dose of prophylaxis, failed to predict the development of pulmonary embolism and hemodynamically significant PE in patients presenting with deep vein thrombosis (DVT), according to the results of a large, retrospective single-center study.

Recent surgery was not associated with the development of hemodynamically significant PE, but the presence of proximal DVT was, according to a report published online in the Journal of Vascular Surgery: Venous and Lymphatic Disorders (2017. doi: 10.1016/j.jvsv.2017.08.015).

Pulmonary embolism Courtesy Wikimedia Commons/Walter Serra, Giuseppe De Iaco, Claudio Reverberi and Tiziano Gherli/Creative Commons License
Pulmonary embolism
Nancy Huynh and her colleagues at the Yale University School of Medicine, New Haven, performed a retrospective review of 838 consecutive patients diagnosed with DVT between January 2013 and August 2014 in a single center. They used multivariable analysis to determine predictors of PE and hemodynamically significant PE.

Their results showed that patients who had undergone recent surgery were less likely to develop hemodynamically significant PE (13.3% vs. 27.2%; P = .01). In contrast, patients with proximal DVT were at higher risk for development of hemodynamically significant PE (80.7% vs. 64.2%; P = .007). They found no association between Caprini score and PE severity (P = .17) or the Caprini score and proximal DVT (P = .89).

“This study shows that the Caprini score does not correlate with the occurrence of PE or the severity of PE. On the other hand, a proximal location of DVT seems to have a high association with hemodynamically significant PE. Such patients may benefit from more aggressive anticoagulant therapy and work-up for PE,” the researchers concluded.

The authors reported that they had no conflicts of interest.
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