Validity of Caprini venous thrombosis risk assessment model in patients with tunneled cuffed dialysis catheters dysfunction and central venous thrombosis

Objective To analyze the validity of Caprini venous thrombosis risk assessment model (Caprini RAM) in the tunneled cuffed dialysis catheters (TCCs) dysfunction patients with central venous thrombosis (CVT). Methods A total of 187 maintenance hemodialysis patients with TCCs dysfunction admitted to West China Hospital of Sichuan University from January 2013 to September 2016 were analyzed retrospectively. According to the chest computed tomography venography results, patients were divided into CVT group and non CVT group. Their general clinical data (age, gender, primary diseases, history of dialysis access, etc.), blood biochemical data (hemoglobin, serum albumin, blood lipid, etc.) and 40 risk factors of Caprini RAM were collected. Caprini RAM scores were computed for risk stratification of thrombosis. Two groups were compared to analyze the value of Caprini RAM in these patients by statistics. Results One hundred and twenty CVT patients and sixty-seven non CVT patients were enrolled. In CVT group the duration of dialysis, hemoglobin and hematocrit were higher than those in non CVT group (all P 0.05). The average score of Caprini RAM in CVT group and non CVT group did not show statistical difference (6.23±1.81 vs 6.19±1.95, P=0.913). All patients were stratified into higher risk level and highest risk level according to Caprini RAM. Higher risk level patients accounted for 18.18% and highest risk level patients accounted for 81.82%. As patients with inequable Caprini RAM scores, their incidence of CVT did not differ statistically (χ2=0.105, P=0.746). CVT incidence rate of higher risk level patients was 61.76%, and of highest risk level patients was 64.70%. Conclusions Caprini RAM verifies that maintenance hemodialysis patients with TCCs dysfunction have high risk of venous thrombosis, but this model fails to distinguish patients between CVT group and non CVT group. Its clinical diagnosis is relatively limited and needs to be further explored. Key words: Renal dialysis; Venous thrombosis; Risk assessment; Tunneled cuffed catheters