AUA 2017: Validation of VTE Score in Major Urologic Cancer Surgery

Boston, MA (UroToday.com) This study discussed the utility of the widely used Caprini Risk assessment score used to predict venous thromboembolism (VTE) and has been validated in surgical patients. The objective of this study was to validate the Caprini risk assessment model in a contemporary cohort of patients undergoing major urologic surgery. They looked at 90-day VTE rates for over 1,000,000 patients undergoing surgery.

They included the following surgeries: radical prostatectomy, radical cystectomy, partial nephrectomy and radical nephrectomy. For this group the incidence of VTE was 1.2% for all risk groups and surgeries. Many of the elements used to calculate the score were associated with development of VTE. In addition the Caprini score had an odds ratio of 1.21 (95%CI: 1.17-1.25, p<0.001). However chemoprophylaxis prevention of VTE was not differentiated based on the Caprini risk score. The areas under the curves were all less than 0.60 for the Caprini score. The conclusion was that the Caprini score was not a good predictor of VTE for this patient cohort.

This study is important, but the rates of VTE at 90-days are lower than reported in many previous studies. In addition, discrimination as to whether VTE prophylaxis was associated with decreased VTEs is not the endpoint the Caprini risk score was designed to predict. For patients undergoing major urologic surgery the Caprini risk score has been previously validated in a heterogeneous patient population. Changing the outcome measure for the Caprini score to predict VTE with or without VTE prophylaxis may not accurately reflect the initial validations of just predicting VTE development. 

Presented By: Ross Krasnow, Brigham and Women’s Hospital 

Written By:
Janet Baack Kukreja, MD, MPH, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX
Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Cancer Research, Department of Urology, UT MD Anderson Cancer Center, Houston TX

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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