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利用 Caprini 评分对接受关节置换术的患者进行风险分层,以预防术后静脉血栓形成。

Utilization of the Caprini Score for Risk Stratification of the Arthroplasty Patient in the Prevention of Postoperative Venous Thrombosis.

机构信息

Department of Orthopaedic Surgery, Syosset Hospital, Northwell Health, Syosset, New York.

Zucker School of Medicine, Hofstra/Northwell, Hempstead, New York.

出版信息

Semin Thromb Hemost. 2022 Jun;48(4):407-412. doi: 10.1055/s-0042-1742739. Epub 2022 Feb 28.

Abstract

Venous thromboembolism (VTE) is a serious and predictable complication following arthroplasty. It has been recognized that a strategy utilizing individualized anticoagulation choices based on patient risk stratification results in improved patient outcomes. A 2013 version of the Caprini Risk Score has previously been validated for use in total joint arthroplasty. A Caprini score of 10 or greater assesses the patient as "high risk" while 9 or less is considered "low risk." Patients scored as "low risk" for postoperative VTE receive enteric coated aspirin 81 mg twice a day for 6 weeks. Patients scored as "high risk" for VTE are prescribed apixaban. This retrospective cohort study was conducted to assess the safety and efficacy of the thromboprophylaxis treatment prescribed based on a standardized risk assessment protocol for the calendar year 2020. Patients having total hip arthroplasty, total knee arthroplasty, revision total hip arthroplasty, revision total knee arthroplasty, or bilateral arthroplasties by 13 surgeons ( = 873) were reviewed. Patients were risk assessed using the Caprini Risk Score and thromboprophylaxis was prescribed based on the score obtained. The annual rate of VTE was 0.2%. The Caprini Risk Score is an effective approach to individualize thromboprophylaxis choices after total joint arthroplasty.

摘要

静脉血栓栓塞症(VTE)是关节置换术后一种严重且可预测的并发症。已经认识到,根据患者风险分层结果制定个体化抗凝策略可改善患者预后。之前已经验证了 2013 年版的 Caprini 风险评分在全关节置换术中的应用。Caprini 评分为 10 或更高者被评估为“高风险”,而 9 或更低者被认为是“低风险”。术后 VTE 低风险患者接受肠溶阿司匹林 81mg,每日两次,持续 6 周。VTE 高风险患者开阿哌沙班。本回顾性队列研究旨在评估 2020 年日历年度基于标准化风险评估方案开具的血栓预防治疗的安全性和有效性。共评估了 13 位外科医生( = 873)行全髋关节置换术、全膝关节置换术、翻修全髋关节置换术、翻修全膝关节置换术或双侧关节置换术的患者。采用 Caprini 风险评分进行风险评估,并根据获得的评分开具血栓预防治疗。VTE 的年发生率为 0.2%。Caprini 风险评分是一种有效的方法,可在全关节置换术后个体化选择血栓预防治疗。

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