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Updated: Feb 14, 2026
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Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
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Risk Stratification for Postoperative Venous Thromboembolism after Endoscopic Sinus Surgery
Daniel M Beswick1,2, Reza Vaezeafshar1, Yifei Ma1
11 Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
Summary
Postoperative venous thromboembolism (VTE) after endoscopic sinus surgery (ESS) is rare, especially for patients with low Caprini scores. Risk stratification can guide VTE prophylaxis to balance safety and necessity.
Area of Science:
- Otolaryngology
- Vascular Surgery
- Epidemiology
Background:
- Venous thromboembolism (VTE) is a significant cause of patient morbidity.
- The incidence of VTE following endoscopic sinus surgery (ESS) is not well-established.
- Standardization of VTE prophylaxis is increasing, necessitating risk stratification.
Purpose of the Study:
- To determine the incidence of VTE within 30 days post-ESS.
- To evaluate the association between Caprini scores and VTE risk after ESS.
- To identify specific risk factors for VTE in ESS patients.
Main Methods:
- Retrospective cohort study of 2369 adult ESS cases from 2008-2016.
- Patients did not receive perioperative chemoprophylaxis.
- VTE identification via screening codes and confirmed through medical records; Caprini scores abstracted.
Main Results:
- Only 4 true VTE events (0.17%) were confirmed among 2369 ESS cases.
- VTE rate was significantly lower for Caprini scores <8 (0.09%) versus ≥8 (2.2%).
- Stroke, central venous access, sepsis, and inpatient status were associated with VTE; prior VTE and hypercoagulability were not.
Conclusions:
- Postoperative VTE following ESS is rare, particularly in patients with low-to-moderate Caprini scores.
- Risk stratification using Caprini scores can inform VTE prophylaxis guidelines for ESS.
- This data supports a tailored approach to VTE prophylaxis, avoiding unnecessary interventions.
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