# Best Practices for Optimizing Patients Undergoing Surgical Procedures to Prevent Postoperative Venous Thromboembolism: A Quality Improvement Project

## TL;DR

This study examined how well VTE risk was assessed and treated in surgical patients, finding that most received appropriate care but improvements are needed.

## Contribution

The study highlights the importance of using the Caprini risk score to improve VTE prevention in surgical patients.

## Key findings

- 17 out of 23 VTE cases were linked to hospitalization and surgery.
- 76% of these patients received appropriate chemical DVT prophylaxis.
- 24% received insufficient prophylaxis based on risk scores.

## Abstract

Introduction

Current studies suggest that both chemical and mechanical venous thromboembolism (VTE) prophylaxis is underused, which is concerning due to the potential lethality of VTEs. The Caprini risk score is a preoperative VTE risk assessment that determines a patient's risk of enduring a VTE. The objective of this study was to examine postoperative cases of VTE to determine if accurate VTE risk stratification was performed and whether appropriate VTE prophylaxis was administered.

Methods

A retrospective analysis was conducted on 23 reported cases of VTE that occurred at a Central Florida hospital from April 1, 2021, to March 31, 2022. Relevant demographic and medical information was gathered from each patient chart to calculate an individual Caprini risk score and determine the type of chemical VTE prophylaxis that was received.

Results

Out of 23 reported cases of VTE in surgical patients, 17 were ultimately determined to have suffered VTE associated with their hospitalization and surgery. Thirteen out of 17 (76%) received appropriate perioperative chemical deep vein thrombosis (DVT) prophylaxis based on the calculated Caprini risk score and corresponding recommendations. Four out of 17 (24%) were determined to have received insufficient perioperative chemical DVT prophylaxis.

Conclusion

Consistent utilization of a DVT/pulmonary embolism (PE) risk stratification tool, such as the Caprini risk score calculator, is essential in the prevention of postoperative VTE. Hospitals can improve the utilization of such a tool and thereby reduce the number of embolic events by making it more visible and accessible to the overseeing provider in the electronic medical record (EMR).