Chapter 10. Venous Thromboembolism
The following is a recommended risk assessment model for estimating VTE risk specific to general surgical patients:
A. The modified CAPRINI Risk Prediction Score
B. The WELLS Risk Prediction Score
C. The PADUA Risk Prediction Score
D. The PESI Risk Prediction Score
Option A: Correct. The CAPRINI risk prediction score has been validated to predict risk of VTE and general surgical patients and is recommended for use by the American College of Chest Physicians – Guidelines for Antithrombotic Therapy Prophylaxis in these patients.
Option B: Incorrect. The WELLS Criteria is a scoring system to evaluate the Pretest Probability of VTE (DVT or PE).
Option C: Incorrect. The PADUA score is used for VTE risk prediction in hospitalized medical patients.
Option D: Incorrect. PESI is a PE severity index used for risk stratification of pulmonary embolism after the diagnosis has been made.
Which VTE prevention strategy is most appropriate for a 74-year-old female who is undergoing a hip fracture surgery, weighs 84 kg (184 lb), has an estimated creatinine clearance of 58 mL/min (0.97 mL/s), and has no known contraindications to anticoagulant drugs?
D. Early ambulation combined with graduated compression stockings (GCS)
Option A: Correct. Approved and guideline recommended options for VTE prophylaxis in hip fracture surgery include LMWH, fondaparinux, LDUH, adjusted dose warfarin, and ASA.
Options B and C: Incorrect. Apixaban and Dabigatran have not been evaluated and are not approved for this indication.
Option D: Incorrect. Ambulation with GCS alone (without anticoagulation) is not an effective option.
Which of the following prophylactic strategies is most appropriate for a 65-year-old patient who is admitted to hospital with left-sided paralysis following an acute hemorrhagic stroke?
B. Intermittent pneumatic compression (IPC)
C. Low Molecular Weight Heparin
Option A: Incorrect. Early ambulation is not effective in this patient at high risk of VTE.
Options C and D: Incorrect. Anticoagulants are contraindicated given that patient had a ...