Risk Score of Pannucci et al for Venous Thromboembolism Following Ventral Hernia Repair

Description

Pannucci et al developed a model for predicting the risk of venous thromboembolism following ventral hernia repair. This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Utah and University of Pennsylvania.

Patient selection: open ventral hernia repair

Outcome: 30-day risk for venous thromboembolism

Parameters:

(1) age in years

(2) ASA classification

(3) functional status

(4) CDC wound class

(5) body mass index (BMI, obesity)

(6) SIRS or sepsis

(7) panniculectomy

(8) open hernia repair

(9) inpatient surgery

(10) prolonged operative time

(11) gastrointestinal (GI) procedure

(12) surgery within past 30 days

Parameter	Finding	Points
age in years	< 45 years	0
	45 to 65 years	1
	> 65 years	2
ASA class	1 or 2	0
	3	1
	4 or 5	2
functional status	independent	0
	partial or total dependence	1
wound class	CDC I	0
	CDC II, III, IV	1
BMI	< 35 kg per sq m	0
	>= 35	1
SIRS or sepsis	absent	0
	present	2
panniculectomy	no	0
	yes	1
open hernia repair	no	0
	yes	1
inpatient surgery	no	0
	yes	4
prolonged operative time	no	0
	yes	3
GI procedure	no	0
	yes	1
recent surgery	no	0
	yes	2

total score =

= SUM(points for all 12 parameters)

Interpretation:

• minimum score: 0

• maximum score: 21

• The higher the score the greater the risk of venous thromboembolism.

• Patients with high scores also had higher rates of 30-day morbidity and mortality.

Score	30-Day Risk VTE
0	0%
1 to 6	0.1 to 0.3%
7 or 8	0.5 to 0.9%
9	1.4%
10	2.1%
11	2.8%
12	3.3%
13 to 21	5%

Performance:

• The area under the ROC curve is 0.79.

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Risk Score of Pannucci et al for Venous Thromboembolism Following Ventral Hernia Repair

Description

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