Appert Scale (Thrombotic Risk Scale) in Aesthetic Plastic Surgery Patients: 3-year Evaluation

Deep vein thrombosis is a complication that can be fatal if left untreated, especially after a surgical procedure. In a previous case-control study, we identified thrombogenic factors generated during cosmetic surgery procedures and found a high incidence of thrombosis. Subsequently, following a consensus of experts and with the participation of 22 judges, the thrombosis risk scale (Appert Total Thrombosis Risk Scale) was developed.

This was a descriptive, prospective, observational study of patients who underwent aesthetic plastic surgery in a 3-year period from June 2021 to June 2024. Demographic variables, such as age and sex, as well as the use of chemoprophylaxis, the result of the Appert scale, the presence of complications, defined as thrombosis events (deep vein thrombosis or pulmonary embolism), and postoperative bleeding, were considered.

Statistical associations were evaluated using the Pearson χ² test; when expected frequencies were less than 5 in more than 20% of the cells, the Fisher exact test was used. Statistical significance was set at a P value of less than 0.05. A total of 345 patients who underwent aesthetic plastic surgery were included in the analysis. According to the dichotomous classification of the Appert scale, 46.4% of patients were classified as low risk and 53.6% as moderate risk. All complications occurred in the moderate-risk group, whereas no events were reported in the low-risk group.

This finding suggested a possible clinical relationship between the level of risk identified using the Appert scale and the occurrence of complications.