cardiology & thrombosisscoring tool

Caprini VTE Risk Score

The Caprini Risk Assessment Model stratifies surgical patients by VTE risk using a comprehensive set of risk factors weighted 1–5 points. It guides the intensity of perioperative thromboprophylaxis from early ambulation alone to pharmacologic prophylaxis with extended duration.

inputs

✓ when to use

Use for all surgical patients undergoing procedures requiring anaesthesia to determine VTE prophylaxis strategy. The Caprini score is the most widely studied surgical VTE risk assessment tool and is endorsed by multiple surgical and thrombosis guidelines.

✗ when not to use

The Caprini score is for surgical patients — use the Padua score for medical inpatients. The many risk factors can make scoring cumbersome; institutional electronic systems often automate this. Not validated for ambulatory surgery with same-day discharge. Always balance VTE risk against bleeding risk (procedure-specific).

clinical pearls

  • The highest-weighted items (5 points each) are: hip/knee arthroplasty, hip/pelvis/leg fracture, stroke, and acute spinal cord injury. Any one of these alone puts the patient at high risk (≥5).
  • Prior VTE (3 points), known thrombophilia (3 points each), and active malignancy (2 points) are powerful risk multipliers. A patient with cancer undergoing major surgery scores at least 4 (cancer 2 + major surgery 2) before any other factors.
  • Extended prophylaxis (up to 4 weeks post-discharge) is recommended for: major cancer surgery, major orthopaedic surgery (hip/knee replacement, hip fracture), and Caprini ≥5 undergoing abdominal/pelvic surgery. Standard prophylaxis covers only the hospital stay.
  • Age points are additive but mutually exclusive (only score the applicable age bracket). A common error is scoring both age 41–60 AND age 61–74.
  • The Caprini score is comprehensive but long. Many hospitals embed it in electronic order sets that auto-calculate the score from the patient's demographics, surgical plan, and medical history.

related tools

paduaVTE risk for medical inpatients (different population)improve-bleedingBleeding risk assessmentasa-psOverall perioperative risk