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VTE Risk Assessment in Gynecologic Oncology Patients

Am J Obstet Gynecol; ePub 2016 Apr 28; Barber, et al

The Caprini score is limited in its ability to discriminate relative venous thromboembolism (VTE) risk among gynecologic oncology patients, with 97% being in the highest risk category; however, sub-stratification of the highest risk groups may allow for relative VTE risk stratification. This according to a study of 17,713 patients undergoing surgery for cervical, ovarian, uterine, vaginal, and vulvar cancers between 2008 and 2013. Among these patients, 1.8% developed of VTE. Researchers found:

• No patients were classified by the Caprini score as low risk; 0.1% were moderate risk, 3.0% were higher risk, and 96.9% were highest risk.

• The Caprini score groupings did not correlate with VTE.

• The high-risk group had a paradoxically higher incidence of VTE of 2.5% vs the highest risk group at 1.7%.

• When the highest risk group of the Caprini score was sub-stratified, it was highly correlated with VTE.

• For the Rogers score, only 0.2% of patients were low risk while 36.9% were medium risk and 63.0% were high-risk.

Citation: Barber EL, Clarke-Pearson DL. The limited utility of currently available venous thromboembolism risk assessment tools in gynecologic oncology patients. [Published online ahead of print April 28, 2016]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2016.04.034.