Pirogov Russian National Research Medical University, Moscow, Russia.
Medical University of Silesia, Katowice, Poland.
Ann Surg. 2023 Jun 1;277(6):929-937. doi: 10.1097/SLA.0000000000005843. Epub 2023 Mar 13.
Estimation of the specific thresholds of the Caprini risk score (CRS) that are associated with the increased incidence of venous thromboembolism (VTE) across different specialties, including identifying the highest level of risk.
Accurate risk assessment remains an important but often challenging aspect of VTE prophylaxis. One well-established risk assessment model is CRS, which has been validated in thousands of patients from many different medical and surgical specialties.
A search of MEDLINE and the Cochrane Library was performed in March 2022. Manuscripts that reported on (1) patients admitted to medical or surgical departments and (2) had their VTE risk assessed by CRS and (3) reported on the correlation between the score and VTE incidence, were included in the analysis.
A total of 4562 references were identified, and the full text of 202 papers was assessed for eligibility. The correlation between CRS and VTE incidence was reported in 68 studies that enrolled 4,207,895 patients. In all specialties, a significant increase in VTE incidence was observed in patients with a CRS of ≥5. In most specialties thresholds of ≥7, ≥9, and ≥11 to 12 were associated with dramatically increased incidences of VTE. In COVID-19, cancer, trauma, vascular, general, head and neck, and thoracic surgery patients with ≥9 and ≥11 to 12 scores the VTE incidence was extremely high (ranging from 13% to 47%).
The Caprini score is being used increasingly to predict VTE in many medical and surgical specialties. In most cases, the VTE risk for individual patients increases dramatically at a threshold CRS of 7 to 11.
评估卡普里风险评分（CRS）的特定阈值，这些阈值与不同专业的静脉血栓栓塞症（VTE）发生率增加相关，包括确定最高风险水平。
准确的风险评估仍然是 VTE 预防的一个重要但往往具有挑战性的方面。一个成熟的风险评估模型是 CRS，它已经在来自许多不同医学和外科专业的数千名患者中得到了验证。
2022 年 3 月对 MEDLINE 和 Cochrane 图书馆进行了检索。纳入的研究报告了（1）入住内科或外科病房的患者，（2）通过 CRS 评估 VTE 风险，（3）报告评分与 VTE 发生率之间的相关性。
共确定了 4562 篇参考文献，对 202 篇论文的全文进行了评估，以确定其是否符合入选标准。有 68 项研究报告了 CRS 与 VTE 发生率之间的相关性，共纳入了 4207895 名患者。在所有专业中，CRS≥5 的患者 VTE 发生率显著增加。在大多数专业中，CRS≥7、≥9 和≥11-12 与 VTE 发生率显著增加相关。在 COVID-19、癌症、创伤、血管、普通、头颈部和胸部手术患者中，CRS≥9 和≥11-12 的患者 VTE 发生率极高（范围为 13%至 47%）。
卡普里评分越来越多地用于预测许多内科和外科专业的 VTE。在大多数情况下，患者的 VTE 风险在 CRS 阈值为 7 至 11 时显著增加。
