Related Experiment Video
Updated: Jul 16, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.0K
Venous Thromboembolism Prophylaxis in Otolaryngologic Patients Using Caprini Assessment
Michael A Edwards1, Emily Brennan2, Amy L Rutt3
1Advanced GI and Bariatric Surgery Division, Department of Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.
The Laryngoscope
|September 23, 2023
Summary
Appropriate venous thromboembolism (VTE) prophylaxis in otolaryngology surgery reduces VTE events, but increases inpatient bleeding. Balancing VTE risk and bleeding is crucial for patient outcomes.
Area of Science:
- Otolaryngology
- Vascular Surgery
- Medical Guidelines
Background:
- Venous thromboembolism (VTE) is a significant risk in otolaryngology (ORL) surgery.
- The Caprini guideline provides a framework for VTE prophylaxis, but its utilization and impact in ORL patients require further investigation.
Purpose of the Study:
- To assess the utilization of Caprini guideline-indicated VTE prophylaxis in elective ORL surgeries.
- To evaluate the impact of this prophylaxis on VTE and bleeding outcomes in ORL patients.
Main Methods:
- Retrospective analysis of 4955 elective ORL surgeries from 2016-2021.
- Logistic regression models used to analyze associations between patient characteristics, prophylaxis, and VTE/bleeding events.
Main Results:
- Only 30% of inpatient and 2% of discharged ORL patients received appropriate VTE prophylaxis.
- Inappropriate prophylaxis was linked to a 3.5-fold increase in inpatient VTE and all pulmonary embolism (PE) events.
- Appropriate prophylaxis reduced inpatient VTE risk but was associated with higher inpatient bleeding; however, post-discharge bleeding occurred only in patients without prophylaxis.
Conclusions:
- Caprini VTE prophylaxis effectively reduces inpatient and post-discharge VTE in ORL surgery.
- The benefits of VTE prophylaxis must be weighed against the increased risk of inpatient postoperative bleeding.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
01:30Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
01:27Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:30Venous Thrombosis I: Introduction
12
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
12