Document Detail


A validation study of a retrospective venous thromboembolism risk scoring method.
MedLine Citation:
PMID:  19779324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Validate a retrospective venous thromboembolism (VTE) risk scoring method, which was developed at the University of Michigan Health System and based on the Caprini risk assessment model, and assess the confounding effects of VTE prophylaxis. BACKGROUND: Assessing patients for risk of VTE is essential to initiating appropriate prophylaxis and reducing the mortality and morbidity associated with deep vein thrombosis and pulmonary embolism. METHODS: VTE risk factors were identified for 8216 inpatients from the National Surgical Quality Improvement Program using the retrospective scoring method. Logistic regression was used to calculate odds ratios (OR) for VTE within 30 days after surgery for risk factors and risk level. A bivariate probit model estimated the effects of risk while controlling for adherence to prophylaxis guidelines. RESULTS: Distribution of the study population by risk level was highest, 52.1%; high, 36.5%; moderate, 10.4%; and low, 0.9%. Incidence of VTE within 30 days was overall 1.4%; by risk level: highest, 1.94%; high, 0.97%; moderate, 0.70%; low, 0%. Controlling for length of hospitalization (>2 d) and fiscal year, pregnancy or postpartum (OR = 8.3; 1.0-68, P < 0.05), recent sepsis (4.0; 1.4-10.9, P < 0.01), malignancy (2.3; 1.5-3.3, P < 0.01), history of VTE (2.1; 1.1-4.1, P < 0.05), and central venous access (1.8; 1.1-3.0, P < 0.05) were significantly associated with VTE. Risk level was significantly associated with VTE (1.9; 1.3-2.6, P < 0.01). The bivariate probit demonstrated significant correlation between the probability of VTE and lack of adherence to prophylaxis guidelines (rho = 0.299, P = 0.013). CONCLUSION: The retrospective risk scoring method is valid and supports use of individual patient assessment of risk for VTE within 30 days after surgery.
Authors:
Vinita Bahl; Hsou Mei Hu; Peter K Henke; Thomas W Wakefield; Darrell A Campbell; Joseph A Caprini
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Annals of surgery     Volume:  251     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-25     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  344-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Information & Decision Support Services, Office of Clinical Affairs, University of Michigan, Ann Arbor, MI 48109-5485, USA. vbahl@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Humans
Middle Aged
Retrospective Studies
Risk Assessment / methods*
Venous Thromboembolism / epidemiology*,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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