Researchers at the University of Michigan Medical School published a study this month showing that a tool called the Caprini Risk Assessment Model should be administered to patients prior to plastic surgery to reduce the risk of blood clots.
In an article published in the Journal of the American College of Surgeons and reviewed online by www.sciencedaily.com, a panel of more than a dozen physicians concluded that risk scores assigned by the Caprini RAM are valid predictors of which patients are more likely than others to develop post-surgical blood clots.
It’s helpful to understand a few terms. In the world of medicine, a blood clot is known as a thrombus. Venal thromboembolism (VTE), the focus of the University of Michigan study, is the process through which clots form and move through the system of veins in the body. DVT, or deep vein thrombosis, is the term used when clots form in deep veins of the body.
Clots can be troublesome in that they may impede blood flow, and as they move around they may reduce the supply of blood to an organ. The most dangerous situation occurs when a clot travels in the bloodstream to, then through, the heart, blocking the arteries leading from the heart to the lungs. This is called a pulmonary embolism, or PE, and it can be fatal.
The Caprini Risk Assessment Model assigns a score to patients based on a variety of risk factors. Some of them are: a history of VTE, cancer, age, obesity and pregnancy or oral contraceptive use. In studying the cases of more than 1,100 plastic surgery patients, those with a Caprini RAM score of 8 or higher had a greater than 10% risk of developing a post-surgical thrombosis. What’s more, the team found that those at higher risk experienced a clot as long as 60 days after surgery.
The review in www.sciencedaily.com notes that 10% of patients who develop a PE will die within an hour of having symptoms. Half of those who survive an episode will suffer permanent heart damage.
Well trained, board certified plastic surgeons are very aware of the possibility of blood clots after surgery.