University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Obstet Gynecol. 2023 Nov 1;142(5):1135-1137. doi: 10.1097/AOG.0000000000005390. Epub 2023 Oct 5.
This quality-improvement retrospective cohort study of patients undergoing major elective nononcologic gynecologic surgery compares the proportion of patients receiving appropriate perioperative venous thromboembolism (VTE) chemoprophylaxis before and after a novel integration of the Caprini risk-assessment model (RAM) into the electronic medical record (EMR). A sample size of 83 patients in each group (166 total) was calculated to provide 80% power and show a 20% increase in appropriate administration of VTE prophylaxis, with an alpha of 0.05. Heparin was appropriately used in 24 patients (28.9%) in the pre-Caprini-RAM group and 39 patients (47.0%) in the post-Caprini-RAM group ( P =.016). There were no differences in bleeding events, transfusions, or other secondary outcomes. Integrating the Caprini-RAM into an EMR for patients undergoing nononcologic gynecologic surgery significantly improved appropriate use of VTE chemoprophylaxis.
这项针对接受大型择期非肿瘤妇科手术的患者的质量改进回顾性队列研究比较了在将 Caprini 风险评估模型 (RAM) 整合到电子病历 (EMR) 前后，接受适当围手术期静脉血栓栓塞症 (VTE) 化学预防的患者比例。计算出每组 83 例患者（共 166 例）的样本量，以提供 80%的功效，并显示 VTE 预防措施的适当使用率增加 20%，α 值为 0.05。在 Caprini-RAM 前组中，肝素在 24 例患者（28.9%）中得到适当使用，在 Caprini-RAM 后组中有 39 例患者（47.0%）得到适当使用（P =.016）。两组在出血事件、输血或其他次要结局方面无差异。将 Caprini-RAM 整合到接受非肿瘤妇科手术的患者的 EMR 中，显著提高了 VTE 化学预防的适当使用率。
