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Laboratory Tests May Improve Accuracy of Risk Stratification for VTE Prevention in Bariatric Patients

May 6, 2025

VanDruff VN, Siddiqui F, Kuchta K, et al. Preoperative Biomarkers and Thromboelastometry According to Caprini Venous Thromboembolism Risk Stratification in Bariatric Patients: Are Clinical Risk Assessments Enough? J Am Coll Surg. 2025, in press.

Risk of postoperative venous thromboembolism (VTE) is significant in obese patients. Stratification of risk can be performed using scoring systems such as the Caprini score, but there are no accepted laboratory tests to improve the accuracy of risk stratification.

This study used laboratory tests (rotational thromboelastometry, C-reactive protein [CRP], D-dimer, and others) in patients stratified into three risk categories using the Caprini score. 100 bariatric surgery patients were included in the study.

Bariatric patients were found to have increased CRP and D-dimer levels compared to normal controls, but there were no differences in results of prothrombotic lab tests in various Caprini score risk groups. Four patients developed postoperative VTE events despite undergoing Caprini Score risk assessments and standard chemoprophylaxis; two of these patients had elevated levels of prothrombotic laboratory tests.

The authors concluded that preoperative CRP, D-dimer, and thromboelastometry were potentially valuable additions to Caprini risk scores for prediction of VTE risk and determination of need for extended chemoprophylaxis.

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