Caprini score is a poor model for predicting risk of thromboembolic events in patients undergoing urethroplasty.

Background: Venous thromboembolism (VTE) is a feared complication in the perioperative period. Patients undergoing urethroplasty are placed in high lithotomy for an extended period, which is known to increase venous stasis, thus possibly increasing VTE risk. Even then, rates of VTE in urethroplasty patients have been shown to be low. We sought to evaluate the applicability of the 2005 Caprini risk assessment module in predicting VTE risk for patients undergoing urethroplasty. Methods: We performed a retrospective cohort study of patients who underwent urethroplasty at our institution from 2019-2024. Ninety-day perioperative outcomes were collected, and patients who had thromboembolic events were isolated for reporting. Risk factors for VTE were quantified using the 2005 Caprini risk assessment model. Results: There were 222 patients eligible for inclusion. Overall, the average Caprini risk score was 4.78, which is between high risk (Caprini score 3-4) and highest risk (score 5-6). Of the patients, 37.8% were categorized as high risk and 55% of patients were categorized as highest risk. Despite this, only one patient had a thromboembolic event; he had a Caprini score of 3. Conclusions: In our cohort, 92.8% of patients were high risk or highest risk for VTE by Caprini risk score, while only a single patient had a thromboembolic event. Although the Caprini score is well accepted for quantifying thromboembolic risk in hospitalized patients, it appears to have limited applicability for patients undergoing urethroplasty, as it overestimates the risk of VTE in this population. Caprini score alone should not be used to guide treatment with chemoprophylaxis in this population.