Thrombosis & Bleeding

Caprini VTE Risk Score for Surgery (Caprini) Calculator

Estimates venous thromboembolism risk after surgery from weighted risk factors to guide prophylaxis.

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · From the Reference tab of the app

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Formula

Score = 1 × (1-point factors) + 2 × (2-point factors) + 3 × (3-point factors) + 5 × (5-point factors); count one age band only
1 point each: age 41–60 years; minor surgery; BMI >25 kg/m²; swollen legs; varicose veins; pregnancy or postpartum; history of unexplained or recurrent spontaneous abortion; oral contraceptives or hormone replacement; sepsis (<1 month); serious lung disease, including pneumonia (<1 month); abnormal pulmonary function; acute myocardial infarction; congestive heart failure (<1 month); history of inflammatory bowel disease; medical patient at bed rest
2 points each: age 61–74 years; arthroscopic surgery; major open surgery (>45 min); laparoscopic surgery (>45 min); malignancy; confined to bed (>72 h); immobilizing plaster cast; central venous access
3 points each: age ≥75 years; history of VTE; family history of VTE; factor V Leiden; prothrombin 20210A; lupus anticoagulant; anticardiolipin antibodies; elevated serum homocysteine; heparin-induced thrombocytopenia; other congenital or acquired thrombophilia
5 points each: stroke (<1 month); elective arthroplasty; hip, pelvis or leg fracture; acute spinal cord injury (<1 month)
Very low 0, low 1–2, moderate 3–4, high ≥5

How it is used

• General and abdominal-pelvic surgery: very low (0) early ambulation only; low (1–2) mechanical prophylaxis, preferably IPC; moderate (3–4) LMWH, low-dose UFH or IPC; high (≥5) LMWH or low-dose UFH, with stockings or IPC added (ACCP 2012).
• High-risk patients having abdominal or pelvic cancer surgery: continue LMWH for 4 weeks after surgery (ACCP 2012).
• High bleeding risk: use mechanical prophylaxis, preferably IPC, until drug prophylaxis is safe (ACCP 2012).
• This is the 2005 Caprini model validated in surgical patients (Bahl 2010) and used by ACCP 2012; the 2013 revision adds factors and its totals are not interchangeable. Orthopedic surgery has its own procedure-based advice (ACCP 2012).

Key points

• Count each factor once and only one age band before adding the tiers.

Same formula as the app. Open it in the web app.

Related one-pagers

• Pulmonary Embolism
• Bleeding, Reversal, HIT and DIC

Related calculators

• Bleeding Risk on Anticoagulation (HAS-BLED)
• Heparin-Induced Thrombocytopenia Probability (4Ts)
• Padua Prediction Score for VTE (Padua)
• Pulmonary Embolism Severity Index (PESI)
• Simplified PESI (sPESI)
• Stroke Risk in Atrial Fibrillation (CHA₂DS₂-VASc)
• Wells Score for PE (Wells)

For education and exam preparation only. Follow your institution’s protocols. For education and exam preparation only. Verify results independently and follow your institution’s protocols. Not a substitute for clinical judgment.