Effect of Risk-Graded Care Based on Caprini Risk Assessment Model on Postoperative Venous Thrombosis and Health-Related Quality of Life in Elderly Patients with Malignancy

Yafang He; Li Wang; Yingfen Zhang

doi:10.30683/1929-2279.2022.11.08

Authors

Yafang He The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
Li Wang The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
Yingfen Zhang The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China

DOI:

https://doi.org/10.30683/1929-2279.2022.11.08

Keywords:

Quality of life, geriatric malignancy, risk-graded care, postoperative, venous thrombosis, Caprini risk assessment model

Abstract

Objective: To investigate the effect of risk-graded care based on Caprini risk assessment model on postoperative deep vein thrombosis and quality of life in elderly patients with malignant tumors.

Methods: Sixty-eight elderly patients with malignant tumors treated by surgery admitted to the Department of Geriatrics of the First Affiliated Hospital of Sun Yat-sen University from April 2021 to September 2021 were selected to be included in the control group and given routine nursing interventions in the geriatrics department, using the Autar deep vein thrombosis risk scale and cluster nursing interventions; Seventy cases of elderly patients with malignant tumors treated by surgery admitted to our geriatric department from October 2021 to 2022 were included in the observation group, and the risk-grading nursing intervention based on the Caprini risk assessment model was used in the observation group on the basis of conventional nursing interventions. The number of cases of deep vein thrombosis, D-II cluster values, average hospitalization days, nursing satisfaction, and quality of life levels were compared between the two groups.

Results: The number of VTE cases and the incidence of VTE in the observation group was 0.43%(3/70) lower than that in the control group (0.89%(6/68)); the average hospital stay in the observation group (13.50+7.45) was lower than that in the control group (15.16+10.60) and the D-II aggregation value in the observation group (2.90+4.32) was lower than that in the control group (4.02+3.91); with statistically significant differences (P<0.05); the satisfaction scores of communication, safety, guidance, nursing, and nursing techniques in the observation group were (41.70+4.21), (48.53+5.12), (38.47+1.90), (56.77+3.33), (47.80+1.68) points, higher than those in the control group (30.11+8.57), (41.69+7.95), (31.75+6.95), (46.87+7.31), (36.0+9.0) points, with statistically significant differences (t-values of -10.634 to -2.404, all P<0.05); the post-intervention scores of general health, physical function, physical function, somatic pain, somatic energy, social function, emotional function, mental health, and spiritual change dimensions of quality of life in the observation group were (67.00+14.95), (65.71+25.24), (63.21+21.59), (83.63+10.65), (74.43+13.45), (70.71+20.95), (67.62+26.60), (62.60+15.12) and (76.79+20.11) and scores were higher than the control group's post-intervention scores of (57.50+19.65), (40.44+27.33), (43.01+25.86), (54.57+15.42), (42.65+20.08), (56.25+26.67), (41.18+28.87), (52.35+18.86), (66.91+23.83) scores than the control group after intervention, with statistically significant differences (t-values of -26.878 to 0.989. all P<0.05).

Conclusions: Risk-graded nursing intervention based on the Caprini risk assessment model can effectively reduce the incidence of postoperative VTE in elderly patients with malignancy, improve nursing satisfaction, and enhance the quality of life of patients.

References

Zhang B, Kim M, Griffiths C, et al. Incidence of Splanchnic Vein Thrombosis After Abdominal Surgery: A Systematic Review and Meta-analysis. Journal of Surgical Research 2020; 245: 500-509. https://doi.org/10.1016/j.jss.2019.07.086

Serrano PE, Parpia S, Valencia M, Simunovic M, Bhandari M, Levine M. Incidence of delayed venous thromboembolic events in patients undergoing abdominal and pelvic surgery for cancer: a systematic review and meta-analysis. ANZ Journal of Surgery 2019; 89(10): 1217. https://doi.org/10.1111/ans.15290

Liufenglin, Zhangtaiping. Guidelines for perioperative thrombosis prevention and management in general surgery in China [J]. Chinese Journal of Practical Surgery 2016; 36(05): 469-474.

Di Nisio M, Van ESN, Buller HR. Deep vein thrombosis and pulmonary embolism[J]. Lancet (London, England), 2016; 388(10063): 3060-3073. https://doi.org/10.1016/S0140-6736(16)30514-1

Rathbun S. Cardiology patient pages. The Surgeon General's call to action to prevent deep vein thrombosis and pulmonary embolism. Circulation 2009; 119(15): e480-2. https://doi.org/10.1161/CIRCULATIONAHA.108.841403

Zhang Z, Lei J, Shao X, Dong F, Wang J, Wang D, Wu S, Xie W, Wan J, Chen H, Ji Y, Yi Q, Xu X, Yang Y, Zhai Z, Wang C. China Venous Thromboembolism Study Group. Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China. Chest 2019; 155(2): 342-353. https://doi.org/10.1016/j.chest.2018.10.040

Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem. Best Pract Res Clin Haematol 2012; 25(3): 235-42. https://doi.org/10.1016/j.beha.2012.06.007

Zhai Z, Kan Q, Li W, Qin X, Qu J, Shi Y, Xu R, Xu Y, Zhang Z, Wang C. DissolVE-2 investigators. VTE Risk Profiles and Prophylaxis in Medical and Surgical Inpatients: The Identification of Chinese Hospitalized Patients' Risk Profile for Venous Thromboembolism (DissolVE-2)-A Cross-sectional Study. Chest 2019; 155(1): 114-122. https://doi.org/10.1016/j.chest.2018.09.020

Yufen M, Haibo D, Lei W, Jianhua S, Ge L, Xiaojie W, Yuan X, Yaping G, Qian G, Xinjuan W. Risk assessment of venous thromboembolism in inpatients: the value of nursing[J]. Chinese Journal of Modern Nursing 2020; (02): 141-143.

Yuan X, Haibo D, Yaping C, Xiaojie W, Yufen MA. Establishment and practice of special nursing group for venous thromboembolism[J]. Chinese Nursing Management 2018; 18(01): 122-124.

Grant PJ, Greene MT, Chopra V, Bernstein SJ, Hofer TP, Flanders SA. Assessing the Caprini Score for Risk Assessment of Venous Thromboembolism in Hospitalized Medical Patients. Am J Med 2016; 129(5): 528-535. https://doi.org/10.1016/j.amjmed.2015.10.027

Chen W, Changqing L, Jingjing A, Yongqiong T, Anque L, Yanli L. Research progress on risk assessment tools of venous thromboembolism[J]. Chinese Nursing Research 2020; 34(23): 4211-4217.

Shujuan X. Assessment and prevention of deep venous thrombosis: a literature review[J]. Journal of Nursing Science 2017; 32(07): 110-112.

Yinhuan X, Hongmei X. Application of Caprini Risk Assessment Scale in non-surgical ICU patients for prediction of high risk thrombosis[J]. Journal of Nursing Science 2019; (3): 4.

Shanna S, Da H. Effect of risk grading nursing on arteriovenous fistula function in patients underwent maintenance hemodialysis[J]. Chinese Nursing Research 2019; 33(19): 3445-3447.

Obi AT, Pannucci CJ, Nackashi A, Abdullah N, Alvarez R, Bahl V, Wakefield TW, Henke PK. Validation of the Caprini Venous Thromboembolism Risk Assessment Model in Critically Ill Surgical Patients. JAMA Surg 2015; 150(10): 941-8. https://doi.org/10.1001/jamasurg.2015.1841

The Surgical Nursing Committee of Chinese Nursing Association; The Nursing Group of Chinese Society of Surgery of Chinese Medical Associaton. Expert consensus on risk assessment and prevention of venous thromboembolism in general surgical patients[J]. Chinese Journal of Nursing 2022; 04: 444-449.

Haiyan L. Professional Committee on Nursing Care, Chinese Chapter of International Union of Angiology; The Society of Endovascology, Chinese Medical Doctor Association.Expert consensus on the application of graduated compression stockings for prevention and treatment of venous thromboembolism[J]. Journal of Interventional Radiology 2019; 09: 811-818.

Hongyan T. Chinese Expert Consensus on Mechanical Prevention of Venous Thromboembolism[J]. National Medical Journal of China 2020; 100(7).

Expert Consensus Committee on Tumor and Thromboemb. Guidelines on prevention and treatment of tumor-associated venous thromboembolism in China (Version 2015) [J]. Chinese Journal of Practical Internal Medicine 2015; 11: 907-920.

Chen XP, Wang JP, Zhang JZ. Surgery [M]. 9th ed. Beijing: People′s Medical Publishing House, 2018; 483-508.

Yuan JY. Classification of nursing outcomes (NOC)[M]. 3rd ed. Wu Y. Beijing: Beijing Med Univ Press, 2006; 1.

Lin YQ, Fang JQ. Development of a Short Form of WHOQOL-OLD[J]. Chinese Journal of Clinical Psychology 2011; (1): 27-30, 34. https://doi.org/10.1093/geront/gnr085

Fang JQ. Measurement method and application of quality of life[M]. Beijing: Beijing Med Univ Press, 2000; 263-268.

Biao Z, Kun C, Fang WJ, Ying WY. Reliability and validity of the Chinese SF-36 scale in evaluating the health quality of life of the elderly population in Zhejiang Province[J]. Chinese Journal of Epidemiology 2008; (12): 1193-119.

The Surgical Nursing Committee of Chinese Nursing Association; The Nursing Group of Chinese Society of Surgery of Chinese Medical Associaton.Expert consensus on risk assessment and prevention of venous thromboembolism in general surgical patients[J]. Chinese Journal of Nursing 2022; 04: 444-449.

Bahl V, Hu HM, Henke PK, Wakefield TW, Campbell DA, Caprini JA. A Validation Study of a Retrospective Venous Thromboembolism Risk Scoring Method. Annals of Surgery 2010; 251(2): 344-350. https://doi.org/10.1097/SLA.0b013e3181b7fca6

Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients. Journal of the American College of Surgeons 2011; 212(1): 105-112. https://doi.org/10.1016/j.jamcollsurg.2010.08.018

Piazza G, Seddighzadeh A, Goldhaber SZ. Double trouble for 2, 609 hospitalized medical patients who developed deep vein thrombosis: prophylaxis omitted more often and pulmonary embolism more frequent. Chest 2007; 132: 554-561. https://doi.org/10.1378/chest.07-0430

Shuang Z, Nan L, Zhijun Z, Hui Z, Hua F. Effects of risk grading nursing on the prevention of postoperative deep vein thrombosis and quality of life in patients undergoing knee arthroscopic surgery[J]. Chinese Journal of Practical Nursing 2022; 38(08): 573-579.