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Caprini VTE Risk Assessment

Predicts venous thromboembolism risk in surgical patients

When to Use

  • Preoperative VTE risk assessment for surgical patients
  • Guides selection of VTE prophylaxis type (mechanical, pharmacologic, or both)
  • Applicable to general, orthopedic, gynecologic, urologic, and other surgical patients

When NOT to Use

  • Medical (non-surgical) patients — use Padua Prediction Score instead
  • Patients already on therapeutic anticoagulation
  • Should not replace clinical judgment for patients with active bleeding or high bleeding risk
Running Total0 / 0

Age

Patient age
years

1-Point Risk Factors

Minor surgery planned(+1 point)
BMI > 25 kg/m²(+1 point)
Swollen legs (current)(+1 point)
Varicose veins(+1 point)
Pregnancy or postpartum (< 1 month)(+1 point)
History of unexplained or recurrent spontaneous abortion(+1 point)
Oral contraceptives or hormone replacement therapy(+1 point)
Sepsis (< 1 month)(+1 point)
Serious lung disease including pneumonia (< 1 month)(+1 point)
Abnormal pulmonary function (COPD)(+1 point)
Acute myocardial infarction(+1 point)
Congestive heart failure (< 1 month)(+1 point)
History of inflammatory bowel disease(+1 point)
Medical patient currently on bed rest(+1 point)
Central venous access(+1 point)

2-Point Risk Factors

Arthroscopic surgery(+2 points)
Major open surgery (> 45 minutes)(+2 points)
Laparoscopic surgery (> 45 minutes)(+2 points)
Malignancy (present or previous)(+2 points)
Confined to bed (> 72 hours)(+2 points)
Immobilizing plaster cast(+2 points)

3-Point Risk Factors

History of DVT/PE(+3 points)
Family history of DVT/PE(+3 points)
Factor V Leiden(+3 points)
Prothrombin 20210A(+3 points)
Lupus anticoagulant(+3 points)
Anticardiolipin antibodies(+3 points)
Elevated serum homocysteine(+3 points)
Heparin-induced thrombocytopenia (HIT)(+3 points)
Other congenital or acquired thrombophilia(+3 points)

5-Point Risk Factors

Stroke (< 1 month)(+5 points)
Elective major lower extremity arthroplasty(+5 points)
Hip, pelvis, or leg fracture (< 1 month)(+5 points)
Acute spinal cord injury (< 1 month)(+5 points)

Risk Stratification Summary

Score 0
Very Low (~0.5%)
Early ambulation
Score 1–2
Low (~1.5%)
Mechanical (IPC/GCS)
Score 3–4
Moderate (~3%)
Pharmacologic ± mechanical
Score ≥5
High (~6%)
Pharmacologic + mechanical, consider extended

Evidence & References

  • Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2-3):70-78.PMID: 15900257
  • Bahl V, Hu HM, Henke PK, Wakefield TW, Campbell DA Jr, Caprini JA. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg. 2010;251(2):344-350.PMID: 19779324
  • Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in Nonorthopedic Surgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e227S-e277S.PMID: 22315263
Disclaimer: This calculator is a clinical decision aid and does not replace clinical judgment. Always consider the full clinical context when making patient care decisions.