Single-center retrospective feasibility and implementation analysis of dynamic Caprini assessment-based graded nursing for in-hospital VTE risk management in a meniscoplasty-dominant arthroscopic meniscus surgery cohort

Vollständiger Abstract

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Objective To evaluate the feasibility and implementation outcomes of dynamic Caprini assessment-based graded nursing for in-hospital venous thromboembolism (VTE) risk management in a meniscoplasty-dominant arthroscopic meniscus surgery cohort. Methods This single-center, retrospective, observational implementation analysis included 90 adult patients who underwent arthroscopic meniscus surgery between January 2024 and December 2025. Caprini assessments were completed at admission (T1), postoperative day 1 (T2), and discharge (T3), and nursing/prophylaxis delivery was assigned according to dynamic risk stratification. Feasibility endpoints included completion of serial assessments, risk-concordant prophylaxis delivery, documentation completeness, and discharge satisfaction. The primary clinical outcome was clinically detected in-hospital deep vein thrombosis (DVT), confirmed by symptom-triggered lower-extremity duplex ultrasonography; pulmonary embolism (PE) was assessed when clinically suspected. Results: Serial Caprini assessment and risk classification were completed in all 90 patients. Basic preventive nursing was delivered to 90/90 patients, mechanical prophylaxis to 73/73 T2 moderate/high-risk patients, and low-molecular-weight heparin (LMWH) to 26/26 T2 high-risk patients. The mean Caprini score increased from T1 (1.87 ± 1.11) to T2 (3.84 ± 1.34, P < 0.001) and decreased at T3 (2.68 ± 1.51, P < 0.001 vs. T2). Moderate-to-high risk classification increased from 26.7% at T1 to 81.1% at T2. Clinically detected in-hospital DVT occurred in 2/90 patients (2.2%; exact 95% CI, 0.3–7.8%), both distal; PE occurred in 0/90 patients (0%; 95% CI, 0.0–4.0%); and minor bleeding occurred in 1/90 patient (1.1%; 95% CI, 0.0–6.0%). No major bleeding was observed. Mean satisfaction was 98.5 ± 1.2 points. Conclusion Dynamic Caprini assessment-based graded nursing was feasible to implement within this single-center meniscoplasty-dominant cohort. The findings describe protocol delivery and clinically detected in-hospital outcomes only and do not establish causal efficacy or total perioperative DVT incidence.