Is the Caprini Score Predictive of Venothromboembolism Events in Orthopaedic Fracture Patients?

OBJECTIVE:Explore the validity of the Caprini Score in orthopaedic patients with lower-extremity fractures. DESIGN:Retrospective cohort study. SETTING:Level I trauma academic medical center. PATIENTS/PARTICIPANTS:Eight hundred forty-eight patients with lower-extremity fractures from 2002 to 2015 with exclusion criteriaminors, follow-up less than 30 days. INTERVENTION:Stratify patients into 2 groupshigh-risk (pelvic and acetabular fractures) and low-risk groups (isolated foot and ankle fractures). MAIN OUTCOME:Caprini Score, fracture classification, length of follow-up, deep vein thrombosis (DVT) chemoprophylaxis, and venothromboembolism (VTE) events [DVT and/or pulmonary embolism (PE)] diagnosed with objective testing. RESULTS:Eight hundred forty-eight patients (499 M; 349 F) 18–93 years of age (average 43.7) with average body mass index of 29. Three hundred high-risk and 548 low-risk patients with no differences in demographics with average follow-up of 288 days. There were 33 (3.9%) VTE events, which were more common in the high-risk group (8%9 DVT, 15 PE) than the low-risk group (1.6%8 DVT, 1 PE) (P < 0.0001). The cutoff that best-predicted VTE events based on receiver-operating curves was 12 (c = 0.74) in the high-risk group, 11 (c = 0.79) in the low-risk group, and 12 (c = 0.83) overall. CONCLUSION:There was a significant lower VTE rate found in the low-risk group, but the Caprini prediction model was not significantly different between the 2 groups. This displays that patient factors play a large role in the development of VTE events independent of injury type. The Caprini score may help identify patients who may require increased protection. LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.