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A Practical Guide to Haemostasis


The CAPRINI Score Stratifying VTE Risk in Surgical Patients

Introduction:

The CAPRINI score is a clinical prediction rule for assessing the risk of VTE in surgical patients.  It has also been evaluated in a retrospective study at predicting the risk of VTE in hospitalised medical patients.



The CAPRINI Score:

 


Select Criteria:

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

Score

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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