Clinical tool for health professionals
Caprini VTE risk score
The Caprini risk assessment model adds up patient and procedure risk factors to estimate the risk of venous thromboembolism after surgery. This is the 2005 version, with the risk groups used in the ACCP 2012 guideline.
Runs in your browser. Nothing you enter is stored or sent. Decision support only: it does not replace clinical judgement.
Risk groups (ACCP 2012)
| Score | Risk group | Approximate VTE risk without prophylaxis | Suggested prophylaxis if bleeding risk is not high |
|---|---|---|---|
| 0 | Very low | Under 0.5% | Early ambulation |
| 1–2 | Low | About 1.5% | Mechanical, preferably intermittent pneumatic compression |
| 3–4 | Moderate | About 3% | Low molecular weight heparin, low-dose unfractionated heparin, or mechanical |
| 5 or more | High | About 6% | Low molecular weight heparin or low-dose unfractionated heparin, plus mechanical |
- Where bleeding risk is high, or the consequences of bleeding would be severe, use mechanical prophylaxis until the bleeding risk falls.
- In high-risk patients having abdominal or pelvic surgery for cancer, the ACCP suggests extended prophylaxis with low molecular weight heparin for 4 weeks.
- The model was built by expert consensus and has been validated in surgical patients. It has not been validated for endovenous ablation; for our own patients we use a procedure-specific assessment.
- The 2013 version of the score (Cronin et al. 2019) adds points for BMI over 40, smoking, diabetes needing insulin, chemotherapy, blood transfusion and surgery lasting more than 2 hours. This calculator uses the 2005 version, on which the ACCP risk groups are based.
Sources
- Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51:70–8.
- Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2 Suppl):e227S–e277S.
- Bahl V, Hu HM, Henke PK, et al. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg. 2010;251:344–50.
- Cronin M, Dengler N, Krauss ES, et al. Completion of the updated Caprini risk assessment model (2013 version). Clin Appl Thromb Hemost. 2019;25:1076029619838052.