Risk Assessment Models for Venous Thromboembolism in Gynecological Patients: A Review of Current Practices and Future Directions

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Abstract

This article introduces and compares risk assessment models for venous thromboembolism in gynecological patients at home and abroad. The models assessed included the Caprini risk assessment model, the G-Caprini risk assessment model, the Rogers risk assessment model, the Autar risk assessment model, the gynecological patient surgical venous thrombosis risk assessment scale, the Wells score, the COMPASS-CAT thrombus risk assessment model, the Khorana risk assessment model, the Padua risk assessment model, and the Chaoyang model. The purpose of this study is to provide a foundation for developing a risk assessment tool for gynecological venous thromboembolism tailored to Chinese patients and to assist clinical health care workers in selecting appropriate risk assessment tools and guiding individualized prevention measures.

References

Bang SM, Jang MJ, Oh D, et al., 2010, Korean Guidelines for the Prevention of Venous Thromboembolism. J Korean Med Sci, 25(11): 1553–1559.

Cantrell LA, Garcia, C, Maitland HS, 2018, Thrombosis and Thromboprophylaxis in Gynecology Surgery. Clin Obstet Gynecol, 61(2): 269–277.

Ratib S, Walker AJ, Card TR, et al., 2016, Risk of Venous Thromboembolism in Hospitalised Cancer Patients in England—A Cohort Study. J Hematol Oncol, 9(1): 60.

Falck-Ytter Y, Francis CW, Johanson NA, et al., 2012, Prevention of VTE in Orthopedic Surgery Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141(2 Suppl): e278S–e325S.

Hill J, Treasure T, 2010, Reducing the Risk of Venous Thromboembolism in Patients Admitted to Hospital: Summary of NICE Guidance. BMJ, 340: c95.

Lang J, Wang C, Qu H, et al., 2017, Expert Consensus on the Prevention of Deep Vein Thrombosis and Pulmonary Embolism After Gynecological Surgery. Chinese Journal of Obstetrics and Gynecology, 52(10): 649–653.

Romano F, Di Lorenzo G, Stabile G, et al., 2022, A Systematic Review of the Guidelines on Venous Thromboembolism Prophylaxis in Gynecologic Oncology. Cancers (Basel), 14(10): 2439.

Li T, Li C, Geng Q, et al., 2019, Research Progress on Risk Assessment Tools for Venous Thromboembolism. Chinese Journal of Modern Nursing, 25(35): 4657–4661.

ACOG, 2007, Practice Bulletin No. 84: Prevention of Deep Vein Thrombosis and Pulmonary Embolism. Obstet Gynecol, 110(2 Pt 1): 429–440.

Qu H, Li Z, Zhai Z, et al., 2015, Predicting of Venous Thromboembolism for Patients Undergoing Gynecological Surgery. Medicine (Baltimore), 94(39): e1653.

Xu Y, Jia Y, Zhang Q, et al., 2021, Incidence and Risk Factors for Postoperative Venous Thromboembolism in Patients with Ovarian Cancer: Systematic Review and Meta-Analysis. Gynecol Oncol, 160(2): 610–618.

Che Y, 2018, The Current Status of Research on the Incidence of Venous Thromboembolism in Obstetrics and Gynecology in China. Chinese Journal of Practical Gynecology and Obstetrics, 34(7): 709–713.

Tasaka N, Minaguchi T, Hosokawa Y, et al., 2020, Prevalence of Venous Thromboembolism at Pretreatment Screening and Associated Risk Factors in 2086 Patients with Gynecological Cancer. J Obstet Gynaecol Res, 46(5): 765–773.

Ma SG, Hu J, Huang Y, 2020, The Risk Factors for Perioperative Venous Thromboembolism in Patients with Gynecological Malignancies: A Meta-Analysis. Thromb Res, 196: 325–334.

Tong T, Yin X, Gao H, 2021, Analysis of the Main Risk Factors for Gynecological Perioperative Venous Thromboembolism. Chinese Medical Journal, 56(5): 566–569.

Yang T, Tian S, Wang Y, et al., 2019, Evaluation of Risk Factors for Venous Thromboembolism in Patients Who Underwent Gynecological Surgery and Validation of a Fast-Rating Assessment Table. Med Sci Monit, 25: 8814–8819.

Tian Q, Li M, 2021, Risk Factors of Deep Vein Thrombosis of Lower Extremity in Patients Undergone Gynecological Laparoscopic Surgery: What Should We Care. BMC Women’s Health, 21(1): 130.

Grupo Desarrollador Del Consenso De Tromboprofilaxis En Cirugia Ginecologica 1, Federacion Colombiana de Obstetricia Y Ginecologia Fecolsog, 2021, Consensus on Thromboprophylaxis in Gynecological Surgery. Rev Colomb Obstet Ginecol, 72(1): 53–68.

Gialeraki A, Valsami S, Pittaras T, et al., 2018, Oral Contraceptives and HRT Risk of Thrombosis. Clin Appl Thromb Hemost, 24(2): 217–225.

Caprini JA, 2010, Risk Assessment as a Guide for the Prevention of the Many Faces of Venous Thromboembolism. Am J Surg, 199(1 Suppl): S3–10.

Rogers SO Jr, Kilaru RK, Hosokawa P, et al., 2007, Multivariable Predictors of Postoperative Venous Thromboembolic Events After General and Vascular Surgery: Results from the Patient Safety in Surgery Study. J Am Coll Surg, 204(6): 1211–1221.

Autar R, 1996, Nursing Assessment of Clients at Risk of Deep Vein Thrombosis (DVT): the Autar DVT scale. J Adv Nurs, 23(4): 763–770.

Wu H, Chu J, Cui L, 2021, Construction of a Risk Assessment Scale for Postoperative Venous Thrombosis in Gynecological Patients. Journal of Nursing, 36(1): 47–49.

Wells PS, Hirsh J, Anderson DR, et al., 1995, Accuracy of Clinical Assessment of Deep-Vein Thrombosis. Lancet, 345(8961): 1326–1330.

Gerotziafas GT, Taher A, Abdel-Razeq H, et al., 2017, A Predictive Score for Thrombosis Associated with Breast, Colorectal, Lung, or Ovarian Cancer: The Prospective COMPASS-Cancer-Associated Thrombosis Study. Oncologist, 22(10): 1222–1231.

Khorana AA, Kuderer NM, Culakova E, et al., 2008, Development and Validation of a Predictive Model for Chemotherapy-Associated Thrombosis. Blood, 111(10): 4902–4907.

Barbar S, Noventa F, Rossetto V, et al., 2010, A Risk Assessment Model for the Identification of Hospitalized Medical Patients at Risk for Venous Thromboembolism: the Padua Prediction Score. J Thromb Haemost, 8(11): 2450–2457.

Tian B, Li H, Cui S, et al., 2019, A Novel Risk Assessment Model for Venous Thromboembolism After Major Thoracic Surgery: A Chinese Single-Center Study. J Thorac Dis, 11(5): 1903–1910.

Liu Q, Zhang K, Liu H, et al., 2022, Comparison of Clinical Value of Different Thrombus Risk Assessment Models in Predicting Postoperative Deep Vein Thrombosis in Patients Undergoing Hysteroscopic Myomectomy. Journal of Xinxiang Medical College, 39(1): 19–24.

Lou Y, Shen Y, 2017, The Effectiveness of Caprini Thrombus Risk Assessment Model in Predicting the Risk of DVT in Patients Undergoing Gynecological Malignant Tumor Surgery. Journal of Southeast University (Medical Edition), 36(3): 333–337.

Gao H, Wang J, Tong T, 2019, Risk Assessment Process and Clinical Practice Management of Gynecological Venous Thromboembolism. Chinese General Practice, 22(12): 1385–1391.

Di P, Liang Z, Xu L, et al., 2016, Study on the Risk Factors of Thrombosis in Patients with Venous Thromboembolism and Cerebral Infarction. Thrombosis and Hemostasis, 22(6): 630–632.

Zhao Y, Wang S, Kong G, et al., 2013, Diabetes and Venous Thromboembolism. Chinese. Journal of Joint Surgery (Electronic Edition), 7(3): 393–396.

Zou D, Zhang W, Xu X, 2020, Observation of the Effect of Graded Intervention based on G-Caprini Model on Preventing Deep Vein Thrombosis in Patients After Gynecological Pelvic Surgery. Internal Medicine, 15(4): 488–489, 492.

Autar R, 2003, The Management of Deep Vein Thrombosis: The Autar DVT Risk Assessment Scale Re-Visited. Journal of Orthopaedic Nursing, 7(3): 114–124.

He C, Chen X, 2016, Research on the Prevention of Lower Limb Deep Venous Thrombosis in Gynecological Surgery Patients through Nursing Intervention Based on Aurar Scale. Journal of Practical Clinical Medicine, 20(22): 113–115.

Qin Y, Wang L, Xu R, et al., 2020, The Application of Autar Assessment Scale in Preventing Deep Vein Thrombosis in Cervical Cancer Patients. General Nursing, 18(19): 2381–2383.

Hu J, 2020, Application of Autar Thrombosis Risk Assessment Scale in Preventing Postoperative Deep Venous Thrombosis in Patients with Gynecological Malignant Tumors. Practical Clinical Nursing Electronic Journal, 5(21): 36.

Guo H, Fang Q, Huang J, et al., 2019, Validation Study of Caprini and Rogers Thrombus Risk Assessment Model in Perioperative Lung Cancer Patients Undergoing Thoracic Surgery? Tumor Prevention and Treatment, 32(8): 660–667.

Kucher N, Koo S, Quiroz R, et al., 2005, Electronic Alerts to Prevent Venous Thromboembolism among Hospitalized Patients. N Engl J Med, 352(10): 969–977.

Tong T, Gao H, Sun T, 2018, Comparative Study on the Predictive Value of Four Common Risk Assessment Models for Postoperative Venous Thromboembolism in Patients with Gynecological Malignancies Practical. Journal of Cardiovascular and Cerebrovascular Diseases, 26(7): 94–98.

Chen X, Pan L, Deng H, et al., 2018, Risk Assessment in Chinese Hospitalized Patients Comparing the Padua and Caprini Scoring Algorithms. Clin Appl Thromb Hemost, 24(9_suppl): 127s–135s.

Zhou H, Hu Y, Li X, et al., 2018, Assessment of the Risk of Venous Thromboembolism in Medical Inpatients using the Padua Prediction Score and Caprini Risk Assessment Model. J Atheroscler Thromb, 25(11): 1091–1104.

Wells PS, Anderson DR, Rodger M, et al., 2003, Evaluation of D-Dimer in the Diagnosis of Suspected Deep-Vein Thrombosis. N Engl J Med, 349(13): 1227–1235.

Cheng Z, Yang M, Zhang Z, et al., 2018, The Predictive Value of Wells Score, Modified Geneva Score Combined with D-Dimer for the Risk of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Embolism. Chinese Journal of Medicine, 98(48): 3925–3929.

Wang S, Chen W, Li J, et al., 2021, The Predictive Value of D-Dimer Combined with Wells Score Correction for Lung Cancer Complicated with Acute Pulmonary Embolism. Hebei Medical, 27(12): 2023–2027.

Liu J, Sun L, Xiang H, et al., 2021, A Comparative Study of the Diagnostic Value of Wells Score, Geneva Score, and YEARS Method in Hospitalized Patients with Suspected Pulmonary Embolism. Journal of Interventional Radiology, 30(6): 552–556.

Xi M, Luo D, Zhou R, et al., 2020, Wells Score and Related Risk Factors Analysis in Patients with Lower Limb Venous Thrombosis. Chinese Medicine, 15(7): 1058–1062.

Spyropoulos AC, Eldredge JB, Anand LN, et al., 2020, External Validation of a Venous Thromboembolic Risk Score for Cancer Outpatients with Solid Tumors: The COMPASS-CAT Venous Thromboembolism Risk Assessment Model. Oncologist, 25(7): e1083–e1090.

Tan K, Liu D, Liu H, et al., 2021, The COMPASS-CAT Model for Predicting the Risk of Venous Thrombosis Associated with Gynecological Malignant Tumors. Chinese General Practice, 19(12): 2132–2135, 2140.

Zhang J, Zhang Y, 2021, The Current Research Status of Risk Assessment Models for Venous Thromboembolism in Obstetrics and Gynecology Patients. Chinese Journal of Maternal and Child Clinical Medicine (electronic version), 17(1): 15–22.

Lyman GH, Khorana AA, Kuderer NM, et al., 2013, Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol, 31(17): 2189–2204.

Hu Y, Li X, Zhou H, et al., 2020, Comparison between the Khorana Prediction Score and Caprini Risk Assessment Models for Assessing the Risk of Venous Thromboembolism in Hospitalized Patients with Cancer: A Retrospective Case Control Study. Interact Cardiovasc Thorac Surg, 31(4): 454–460.

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