Caprini venous thromboembolism risk assessment permits selection for postdischarge prophylactic anticoagulation in patients with resectable lung cancer

Hachey, Krista J.; Hewes, Philip D.; Porter, Liam P.; Ridyard, Douglas; Rosenkranz, Pamela; McAneny, David; Fernando, Hiran C.; Litle, Virginia R.

doi:10.1016/j.jtcvs.2015.08.039

Cited by 91 publications

(100 citation statements)

References 30 publications

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“…To date, risk assessment tools, including the Caprini VTE risk model, have demonstrated success in identifying patients at risk for postdischarge VTE [28,29]. Our data corroborate several risk factors used in the Caprini model, including older age, obesity, and extended operative duration [29].…”

Section: Commentsupporting

confidence: 75%

Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection

Thomas

Arnold

Hoag³

et al. 2018

The Annals of Thoracic Surgery

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Significant proportions of VTE events occur after hospital discharge. Although there are data to suggest that the risk for VTE extends beyond this period, few patients are managed with postdischarge prophylaxis. These data suggest that postdischarge prophylaxis should be considered for those patients at high risk for VTE, particularly for older patients, those who are obese, and after extended or lengthy resections.

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Section: Commentsupporting

confidence: 75%

Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection

Thomas

Arnold

Hoag³

et al. 2018

The Annals of Thoracic Surgery

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“…The Hachey and colleagues cohort study 20 was a retrospective chart review from 2005 to 2013, and as such, all reported cases were diagnosed secondary to symptoms, potentially explaining the overall lower VTE incidence. Additionally, Hachey and colleagues 20 reported that 92% of VTE occurred in postthoracotomy patients, whereas our cohort consisted of 47% incident cases following video-assisted thoracoscopic surgery, and so the results of Hachey and colleagues 20 may not be comparable to institutions with a much greater proportion of minimally invasive cases.…”

Section: Discussionmentioning

confidence: 76%

Postdischarge venous thromboembolic complications following pulmonary oncologic resection: An underdetected problem

Agzarian

Hanna

Schneider

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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“…Despite analysing data from over 10,660 patients, all but one of the included studies were retrospective with marked heterogeneity, limiting the ability to pool the data. The VTE estimates reported in these reviews are in stark contrast to more recent literature demonstrating a higher incidence rate (7,17,18). Using computed tomography (CT) pulmonary angiogram and lower extremity venous Doppler ultrasound screening, we recently found that the prevalence of post-lung cancer resection VTE was 12.1%, and that over 75% patients were asymptomatic (6), highlighting the potential underdetection of this phenomenon.…”

Section: Discussionmentioning

confidence: 91%

Practice patterns in venous thromboembolism (VTE) prophylaxis in thoracic surgery: a comprehensive Canadian Delphi survey

Agzarian¹,

Linkins²,

Schneider³

et al. 2017

J. Thorac. Dis.

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Background: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. Methods: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada. Participants were asked to rate each parameter on a ten-point scale. Agreement was determined a priori as an item reaching a coefficient of variation of ≤30% (0.3), with the item then discontinued from later rounds. Results: In total, 72, 57 and 50 respondents participated in three consecutive rounds, respectively.Consensus was reached on previous VTE, age, cancer diagnosis, thrombophilia, poor mobilization, extended resections, and pre-operative chemotherapy as risk factors. Consensus on risk factors impacting extended prophylaxis decisions was achieved on cancer diagnosis, obesity, previous VTE and poor mobilization.With respect to perioperative prophylaxis, once daily low-molecular-weight heparin (LMWH) was the only parameter that demonstrated agreement as a common practice pattern. No agreement was achieved regarding the role of mechanical prophylaxis, unfractionated heparin (UFH) or timing of initiation of perioperative treatment. VTE prophylaxis until discharge reached agreement but there was substantial variability regarding the role of extended prophylaxis. Conclusions: There is agreement between Canadian clinicians treating patients with thoracic malignancies regarding most risk factors for VTE, but there is no agreement on timing of initiation of prophylaxis, the agents used or factors mandating usage of extended prophylaxis.

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Caprini venous thromboembolism risk assessment permits selection for postdischarge prophylactic anticoagulation in patients with resectable lung cancer

Abstract: One third of VTE events occurred after discharge. Postoperative VTE incidence was correlated with increasing Caprini scores. Patients in the high risk group had an incidence of 10.3%. Elevated scores may warrant extended chemoprophylaxis for patients after discharge.

Cited by 91 publications

References 30 publications

Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection

Timing and Risk Factors Associated With Venous Thromboembolism After Lung Cancer Resection

Postdischarge venous thromboembolic complications following pulmonary oncologic resection: An underdetected problem

Practice patterns in venous thromboembolism (VTE) prophylaxis in thoracic surgery: a comprehensive Canadian Delphi survey

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