Medical AICaprini Score (2005) for venous thromboembolism risk
A weighted risk assessment model that totals individual venous thromboembolism risk factors (worth 1, 2, 3, or 5 points each) to place a surgical patient into a risk category from very low to high. The category guides whether mechanical prophylaxis, pharmacological prophylaxis, or both are appropriate, always balanced against bleeding risk.
How to measure each input
- Age
- Age contributes a single value only: 41 to 60 scores 1, 61 to 74 scores 2, and 75 or older scores 3. It is never counted more than once.
- Surgery type
- Match the planned operation: minor surgery scores 1; arthroscopic, major open (> 45 min), or laparoscopic (> 45 min) surgery scores 2; elective major lower-extremity arthroplasty scores 5.
- Thrombophilia and prior VTE
- A personal or family history of VTE and laboratory thrombophilias (factor V Leiden, prothrombin G20210A, lupus anticoagulant, anticardiolipin antibodies, elevated homocysteine, heparin-induced thrombocytopenia) each score 3 points.
- Female-specific factors
- For women only, add 1 point each for oral contraceptives or hormone replacement therapy, pregnancy or postpartum within 1 month, and a history of unexplained or recurrent spontaneous abortion.
Interpretation
| Band | Meaning |
|---|---|
| 0, very low risk | Very low risk of venous thromboembolism. Early and frequent ambulation is generally sufficient; specific prophylaxis is usually not required. |
| 1 to 2, low risk | Low risk. Mechanical prophylaxis (intermittent pneumatic compression) is generally recommended, with early ambulation. |
| 3 to 4, moderate risk | Moderate risk. Pharmacological prophylaxis or mechanical prophylaxis is generally recommended; in higher-bleeding-risk patients, mechanical prophylaxis is preferred. |
| >= 5, high risk | High risk. Combined pharmacological and mechanical prophylaxis is generally recommended unless bleeding risk is prohibitive, and an extended duration may be considered for some procedures. |
Pitfalls, exclusions and caveats
- Designed for surgical patients. For hospitalised medical (non-surgical) patients, the Padua Prediction Score is the better-matched tool.
- The 2005 version differs from the 2010 and later versions in some item wording and point values. Make sure the version you score matches the version cited in your protocol.
- It estimates clot risk only. Always weigh the recommended prophylaxis against the patient's bleeding risk before prescribing an anticoagulant.
- Age and the female-specific items are easy to mis-score. Age is a single band, and the hormonal and pregnancy items apply to women only.
- Published risk-category cutoffs vary by surgical specialty (for example a higher threshold in joint arthroplasty). The very-low to high bands here are the widely used general stratification.
Sum the points for every factor present. 1 point: age 41 to 60, minor surgery, BMI > 25, swollen legs, varicose veins, sepsis or pneumonia within 1 month, abnormal pulmonary function or COPD, acute MI, congestive heart failure within 1 month, inflammatory bowel disease, medical patient on bed rest, plus the other listed 1-point items. 2 points: age 61 to 74, arthroscopic surgery, major open surgery > 45 min, laparoscopic surgery > 45 min, malignancy, confined to bed > 72 hours, immobilising plaster cast, central venous access. 3 points: age >= 75, history of VTE, family history of VTE, factor V Leiden, prothrombin G20210A, lupus anticoagulant, anticardiolipin antibodies, elevated homocysteine, heparin-induced thrombocytopenia, other congenital or acquired thrombophilia. 5 points: stroke within 1 month, elective major lower-extremity arthroplasty, hip, pelvis, or leg fracture, acute spinal cord injury with paralysis within 1 month, multiple trauma within 1 month. Women add 1 point each for oral contraceptives or hormone replacement, pregnancy or postpartum within 1 month, and history of unexplained or recurrent spontaneous abortion.The Caprini risk assessment model (2005 version) was described by Joseph A. Caprini. This implementation is an educational tool and is not affiliated with the original author or any guideline body.
Frequently asked
Which version of the Caprini score is this?
This is the 2005 version, the most widely used and validated form (validated by Bahl et al. in 2010). Later 2010 and 2013 versions adjust some item wording and point values, so confirm which version your local protocol expects.
How do the risk categories map to prophylaxis?
Broadly: 0 (very low) needs early ambulation only; 1 to 2 (low) favours mechanical prophylaxis; 3 to 4 (moderate) favours pharmacological or mechanical prophylaxis; 5 or more (high) favours combined pharmacological and mechanical prophylaxis. Bleeding risk always tempers the choice.
Why does age appear as a single dropdown rather than several checkboxes?
Age contributes one mutually exclusive value (1, 2, or 3 points). A single dropdown prevents accidentally counting more than one age band, which would inflate the score.
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