The CAPRNI Algorithm

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1. The Caprini algorithm has been used to assess the risk of VTE in medical patients but was unable to identify a subset of medical patients who would benefit from pharmacological thromboprophylaxis.

1. Caprini JA, Arcelus JI, et al. Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost. 1991; 17 Suppl 3: 304-12.

2. Gould MK, Garcia DA, 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: e227S-e77S.

3. Kearon C, Akl EA, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141: e419S-e96S.

4. Jacobs B and Pannucci C. Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients. Semin Thromb Hemost. 2017; 43: 449-59.

Age
	≤ 40 Years	1 Point
	41-60 Year	1 Point
	61-74 Years	2 Points
	≥75 Years	3 Points
Type of Surgery
	Minor	1 Point
	Major Surgery [>45 minutes]; Laparoscopic Surgery [>45 minutes] or Arthroscopic Surgery	2 Points
	Elective Arthroplasty	5 Points
Additional Recent [<1 Month] Events
	Congestive Cardiac Failure	1 Point
	Major Surgery	1 Point
	Serious Lung Disease including Pneumonia	1 Point
	Sepsis	1 Point
	Immobilisation due to Plaster Case	2 Points
	Hip, Pelvis or Leg fracture	5 Points
	Stroke	5 Points
	Major/Multiple Trauma	5 Points
	Acute Spinal Cord Injury	5 Points
Venous Disorder or Prothrombotic Disorder
	Swollen Legs	1 Point
	Visible Varicose Veins	1 Point
	Central Venous Access	2 Points
	Personal History of VTED	3 Points
	Family History of VTED	3 Points
	Factor V Leiden	3 Points
	Prothrombin G20210A Mutation	3 Points
	Hyperhomocysteineaemia	3 Points
	Lupus Anticoagulant Positive	3 Points
	Heparin-Induced Thrombocytopaenia [HIT]	3 Points
	Other Inherited or Acquired Prothrombotic Abnormality	3 Points
Mobility
	Fully mobile	1 Point
	Medical Patient on Bed-rest	1 Point
	Confined to Bed [>72 hours]	2 Points
Other Significant History or PMH
	Inflammatory Bowel Disease [IBD]	1 Point
	Pregnant or Post-partum [<1 month]	1 Point
	Use of OCP or HRT	1 Point
	History of Unexplained or Recurrent Spontaneous Abortion [≥3]	1 Point
	Abnormal Pulmonary Function [e.g. COPD]	1 Point
	Acute MI	1 Point
	BMI >25 kg/m²	1 Point
	Malignancy [Current or Past]	2 Points
	Other Risk Factors e.g. Smoking/Diabetes mellitus/Chemotherapy/Prolonged Surgery >2 hours]	1 Point

Interpretation: Excludes Patients undergoing Plastic or Reconstructive Surgery
0: Very Low	Observed Risk Symptomatic VTED: N/A
1 - 2: Low	Observed Risk VTED: 0.7%
3 - 4: Moderate	Observed Risk VTED: 1.0%
≥5: High	Observed Risk VTED: 1.9%

Interpretation: Patients undergoing Plastic or Reconstructive Surgery
0: Very Low	Observed Risk Symptomatic VTED: N/A
1 - 2: Low	Observed Risk VTED: 0.6%
3 - 4: Moderate	Observed Risk VTED: 1.3%
≥5: High	Observed Risk VTED: 2.7%

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