MDCalc

Caprini Score for Venous Thromboembolism (2005)

Stratifies VTE risk in surgical patients, guiding prophylaxis decisions.

Age, years

Sex

Type of surgery

Minor surgery does not refer to type of surgery but rather length of anesthesia <45 minutes.

Major surgery refers to procedures with general or regional anesthesia time >45 minutes are included. These include open, laparoscopic, or arthroscopic procedures. Re-operations during the same hospitalization count for 2 points each if the anesthesia time exceeds 45 minutes.

Major lower extremity arthroplasties are high-risk procedures. However if additional risk factors are present that further increases the risk. It has been shown that in scores ≥10 the VTE risk is significantly greater. If the procedure is being done as a result of a hip fracture, preoperative screening may be beneficial.

Recent (<1 month) event

Major surgery
CHF
Sepsis
Pneumonia
Immobilizing plaster cast
Hip, pelvis, or leg fracture
Stroke
Multiple trauma
Acute spinal cord injury causing paralysis

Venous disease or clotting disorder

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
Bed rest is defined as not being able to walk 30 feet (10 meters) at one time. Bathroom privileges or walking in the room are not considered ambulation. Walking this distance reduces the VTE risk by 50%. Click here for VIDEO. PE mortality increased for those immobile for >4 days.

Other present and past history

History of inflammatory bowel disease
BMI >25
Acute MI
COPD

Present or previous malignancy

Other risk factors

Result:

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Advice

While many hospitals have developed institution-wide policies for VTE prophylaxis based on risk assessment models, the decision for type and duration of VTE prophylaxis should ultimately be left up to the surgeon’s best clinical judgment based on individual patient factors.

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