Risk Assessment of Venous Thromboembolism among Hospitalized Patients using the Modified 3-Tier Caprini Score at Services Hospital, Lahore: A Cross-Sectional Study
DOI:
https://doi.org/10.47489/szmc.v40i3.817Keywords:
risk assessment, hospital admission, thromboembolism, factors associated, Caprini score, thromboembolic risk (VTE)Abstract
Background: Venous thromboembolism (VTE) is a leading, yet largely preventable, complication of hospitalization. Hospitalization itself contributes to immobility, acute illness, and invasive interventions and thus significantly increases this baseline risk. Early identification of at-risk patients is essential to interrupting the pathway from risk exposure to clinical event and allows appropriate thromboprophylaxis to be initiated before complications such as pulmonary embolism or post-thrombotic syndrome develop.
Objective: The objective of the study was to assess the risk of venous thromboembolism among hospitalized patients using the modified 3-tier Caprini score at Services Hospital Lahore.
Methodology: A cross-sectional study was conducted among 350 patients using non-random convenience sampling technique (sample size calculated from the WHO sample size calculator) in the medical, surgical and allied wards (medical, surgical, gynecology, orthopedics and others) of Services Hospital Lahore. The modified 3-tier Caprini score was used to assess the risk of thromboembolism among hospitalized patients in these wards. The data were collected over a period of 3 months from November 2024 to January 2024. Bivariate analysis using the chi-square and Fisher's exact test was applied; identified variables were entered into a multivariable binary logistic regression to identify factors associated with high Caprini defined-VTE risk, with adjusted odds ratios (AOR) and 95% confidence intervals.
Results: The study did not find any hospitalized patient at low risk; 124 patients (35.4%) were at moderate risk and 226 patients (64.6%) were found at high risk. All departments of the hospital included in the study were at similar risk of developing venous thromboembolism. Male gender (AOR = 1.49, p = 0.038) and employment (AOR = 1.52, p =0.046) were associated independently with Caprini defined high-risk VTE. Age, blood clotting disorders (AOR = 3.36, p < 0.001), trauma (AOR = 6.48, p < 0.001), and stillbirth (AOR = 8.94, p < 0.001) were also associated with high risk VTE score (p < 0.05 with a 95% confidence level).
Conclusion: The findings highlight a substantial prevalence of high risk VTE among hospitalized patients, with consistent risk observed across all hospital departments, emphasizing the necessity of vigilant risk assessment and preventive measures in all departments of hospital settings. Age, employment, gender, trauma, blood clotting disorders, and stillbirths showed strong associations.
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