Cardiovascular

Caprini VTE Risk Score

Assess VTE risk in surgical patients to guide prophylaxis decisions.

When to use: Use Caprini score preoperatively to stratify VTE risk in surgical inpatients and determine appropriate thromboprophylaxis. High-risk patients (score ≥5) benefit from combined pharmacological (LMWH/UFH) and mechanical (pneumatic compression devices) prophylaxis. Extended pharmacoprophylaxis for 28 days is indicated after major abdominal/pelvic cancer surgery.

Calculator

1-Point Risk Factors (select cumulative count)Age 41-60, minor surgery, BMI>25, swollen legs, varicose veins, pregnancy/postpartum, recurrent miscarriage, OCP/HRT, sepsis <1mo, serious lung disease, impaired pulmonary function, acute MI, CHF, IBD, medical patient at bed rest

2-Point Risk Factors (select cumulative count)Age 61-74, arthroscopic surgery, malignancy, laparoscopic surgery >45min, confined to bed >72h, immobilising cast, central venous access

3-Point Risk Factors (select cumulative count)Age ≥75, prior VTE, family history VTE, factor V Leiden, prothrombin 20210A, lupus anticoagulant, anticardiolipin antibodies, elevated homocysteine, HIT, other congenital/acquired thrombophilia

5-Point Risk FactorsElective arthroplasty, hip/pelvis/leg fracture, stroke within 1 month, acute spinal cord injury — each worth 5 points

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Formula

Caprini Score = Σ(1-pt factors) + Σ(2-pt factors ×2) + Σ(3-pt factors ×3) + Σ(5-pt factors ×5) ≤1 = Very low, 2 = Low, 3–4 = Moderate, ≥5 = High (pharmacoprophylaxis recommended)

Key Points for NEET PG

VTE (DVT + PE) is the most common preventable cause of in-hospital death — prophylaxis is mandatory in moderate-high risk surgical patients.
Caprini ≥5 = High risk: prescribe LMWH (enoxaparin 40 mg/day) + graduated compression stockings.
High-risk surgeries with 5 points each: total hip/knee replacement, hip fracture, spinal cord injury, stroke within 1 month.
Contra-indications to LMWH: active bleeding, HIT, very high bleeding risk — use mechanical compression only in these cases.
LMWH vs UFH: LMWH preferred (once daily, predictable pharmacokinetics, no routine monitoring needed); UFH in renal failure (CrCl <30).

References

Caprini JA. Thrombosis risk assessment as a guide to quality patient care · Dis Mon (2005)

Gould MK et al. Prevention of VTE in Nonorthopedic Surgical Patients: ACCP Evidence-Based Clinical Practice Guidelines · Chest (2012)

For educational purposes only. Not for clinical decision-making without professional oversight.