Risk Factors for Venous Thromboembolism in Surgical Patients Caprini online calculator

Nataliia Lopina April 28, 2021

Risk Assessment Scale in Surgical Patients – Risk Factors for Venous Thromboembolism Caprini / recommendations of the American College of Chest Physicians (АССР, 2012) on the prevention of VTE (J. Chest, 2012).

Caprini Score:	Risk category	Risk percent	Recommended prophylaxis	Duration of chemoprophylaxis
0	0	0	0	0

Details:

Risk factor	Value	Score

Age (years)	< 40	0
	41-60	1
	61-74	2
	≥75	3
Type of surgery
	Without surgery	0
	Minor elective surgery	1
	Major surgery (over 45 min.), laparoscopic over 45 min. or arthroscopic	2
	Elective major lower extremity arthroplasty	5
Recent (<1 month) events
	History of major surgery	1
	Congestive heart failure	1
	Sepsis	1
	Pneumonia	1
	Immobilization for medical reasons (plaster cast)	2
	Hip, pelvis, or leg fracture	5
	Stroke	5
	Multiple trauma	5
	Acute spinal cord injury causing paralysis	5
Venous disease or clotting disorder
	Varicose veins	1
	Current swollen legs	1
	Current central venous access	2
	History of DVT/PE	3
	Family history of thrombosis	3
	Positive Factor V Leiden	3
	Positive prothrombin 20210A	3
	Elevated serum homocysteine	3
	Positive lupus anticoagulant	3
	Elevated anticardiolipin antibody	3
	Heparin-induced thrombocytopenia	3
	Other congenital or acquired thrombophilia	3
Mobility
	Normal, out of bed	0
	Medical patient currently on bed rest	1
	Patient confined to bed >72 hours	2
Other present and past history
	History of inflammatory bowel disease	1
	Obesity (BMI >25)	1
	Acute myocardial infarction	1
	Chronic obstructive pulmonary disease	1
	Present or previous malignancy	2
	Other risk factors other risk factors, on oral contraceptives or hormone replacement (if female), history of unexplained stillborn, ≥3 spontaneous abortions, or premature birth with toxemia or growth-restricted infant (if female)	1

Results:

Caprini Score	Risk category	Risk percent*	Recommended prophylaxis**	Duration of chemoprophylaxis
0	Lowest	Minimal	Early frequent ambulation only, OR at discretion of surgical team: Pneumatic compression devices OR graduated compression stockings	During hospitalization
1–2	Low	Minimal	Pneumatic compression devices ± graduated compression stockings	During hospitalization
3–4	Moderate	0.7%	Pneumatic compression devices ± graduated compression stockings	During hospitalization
5–6	High	1.8%	Pneumatic compression devices AND low dose heparin OR low molecular weight heparin	7–10 days total
7-8	High	4.0%	Pneumatic compression devices AND low dose heparin OR low molecular weight heparin	7–10 days total
≥9	Highest	10.7%	Pneumatic compression devices AND low dose heparin OR low molecular weight heparin	30 days total

Risk by classification АССР 2012 and the number of points on the Caprini VTE risk scale in surgical patients

	0 points	1 point	2 points	3 points	5 points
Age (years)	≤40	41-60	61-74	≥75	—
Type of surgery	—	Minor	Major >45 min, laparoscopic >45 min, arthroscopic	—	Elective major lower extremity arthroplasty
Recent (<1 month) event	None	Major surgery, CHF, sepsis, pneumonia, pregnancy or postpartum (if female)	Immobilizing plaster cast	—	Hip, pelvis, or leg fracture; stroke; multiple trauma; acute spinal cord injury causing paralysis
Venous disease or clotting disorder	None	Varicose veins, current swollen legs	Current central venous access	History of DVT/PE, family history of thrombosis, positive Factor V Leiden, positive prothrombin 20210A, elevated serum homocysteine, positive lupus anticoagulant, elevated anticardiolipin antibody, heparin-induced thrombocytopenia, other congenital or acquired thrombophilia	—
Mobility	Normal, out of bed	Medical patient currently on bed rest	Patient confined to bed >72 hours	—	—
Other present and past history	None	History of inflammatory bowel disease, BMI >25, Acute MI, COPD, other risk factors, on oral contraceptives or hormone replacement (if female), history of unexplained stillborn, ≥3 spontaneous abortions, or premature birth with toxemia or growth-restricted infant (if female)	Present or previous malignancy	—	—