VENOUS THROMBOEMBOLISM RISK ASSESSMENT IN ASIAN SURGICAL PATIENTS: SHOULD IT DIFFER FROM WESTERN POPULATION? leelimi@um.edu.my

195-03

VENOUS THROMBOEMBOLISM RISK ASSESSMENT IN ASIAN SURGICAL PATIENTS: SHOULD IT DIFFER FROM WESTERN POPULATION?

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Malaysia

Oral or Poster

Rising trend of venous thromboembolism (VTE) incidence in Asia has called for improved risk assessment and thromboprophylaxis. Caprini risk assessment model (RAM) is widely used among Western population but its applicability in Asia remains contentious. This study aims to compare efficacy of VTE risk assessment between Caprini model and the new model based on local factors.

VTE risk factors were retrospectively identified for 4206 surgical inpatients in a tertiary hospital in Malaysia. Logistic regression was used to compute the risk factors and levels odds ratios (OR) for VTE within 90 days of hospitalisation. Receiver operating characteristics curves were performed to determine the area under curve (AUC) for both RAMs.

Incidence of VTE was 0.5%; by risk level: Caprini RAM - low, 0.16%; moderate, 0.37%; high, 2.12%; New RAM – low, 0.09%; moderate, 1.91%; high, 3.47%. Age 40-60 (OR = 11.39; 1.93 – 67.08), age >60 (9.12; 1.46 – 57.04), pregnancy (118.83; 8.78 – 1608.4), obesity, BMI ≥30 (18.06; 2.91 – 112.20), history of prior VTE (172.34; 37.05 – 801.52) and thrombophilia (714.12; 7.62 – 66886.4) were significantly associated with VTE. New RAM moderate (16.49; 4.45 – 61.17) and high (18.27; 3.79 – 87.98) risk level yielded markedly higher odds ratio than Caprini high risk (5.97; 2.13 – 16.69). AUC difference between Caprini (0.795) and new RAM (0.849) was statistically significant, P = 0.004.

VTE incidence in Asian surgical patients is low. The new RAM using Asian VTE guidelines has better VTE risk assessment efficacy than Caprini’s.