Caprini VTE Risk Score
Venous Thromboembolism Risk Stratification
1 Point Each
1 point per risk factor
2 Points Each
2 points per risk factor
3 Points Each
3 points per risk factor
5 Points Each
5 points per risk factor
Risk Summary
Total Score0
Risk CategoryVery Low
Predicted Risk< 0.5%
Score: 0
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Pre-operative VTE risk stratification for all surgical patients
Hospital admission VTE risk assessment for medical patients
Guidance for thromboprophylaxis prescribing decisions
Identifying patients who require extended-duration VTE prophylaxis
Standardized risk documentation for quality improvement and regulatory compliance
Clinical decision support for balancing VTE risk vs. bleeding risk
Patient Population
Designed for adult surgical patients across all surgical specialties. Also validated in medical inpatients, critical care patients, and oncology patients. The most widely used VTE risk assessment model in the United States.
How it Works
Scoring Components
| Score | Risk Factors | Examples |
|---|---|---|
| 1 point | 12 factors | Age 41-60, minor surgery, BMI >25, CHF, COPD, MI, bed rest |
| 2 points | 7 factors | Age 61-75, malignancy, major surgery >45 min, cast immobilization |
| 3 points | 7 factors | Age >75, personal/family VTE history, thrombophilia, APS |
| 5 points | 4 factors | Stroke <1 mo, elective arthroplasty, hip fracture, spinal cord injury |
Risk Stratification
Total Score = Sum of points for all selected risk factors
Score 0-1: Very Low Risk (VTE incidence <0.5%)
Score 2: Low Risk (VTE incidence ~1.5%)
Score 3-4: Moderate Risk (VTE incidence ~3.0%)
Score 5+: High Risk (VTE incidence ~6.0%)
Clinical Pearls
Prophylaxis Recommendations
| Risk Category | Score | Recommended Prophylaxis |
|---|---|---|
| Very Low | 0-1 | Early ambulation; no pharmacologic prophylaxis |
| Low | 2 | Mechanical prophylaxis (SCDs or compression stockings) |
| Moderate | 3-4 | Pharmacologic prophylaxis (LMWH or unfractionated heparin) or mechanical |
| High | 5+ | Dual prophylaxis: pharmacologic + mechanical; consider extended-duration LMWH |
Key Considerations
The Caprini Score is additive — each risk factor contributes independently to total risk
Bleeding risk must be assessed separately; the Caprini Score does not account for hemorrhage risk
Extended-duration prophylaxis (up to 35 days) is recommended for high-risk surgical patients
The score should be reassessed whenever clinical status changes (new surgery, complication)
Neuraxial anesthesia timing must be coordinated with prophylactic anticoagulation
Common Pitfalls
Do not double-count related conditions (e.g., malignancy and chemotherapy)
Ensure accurate timing: factors listed as "<1 mo" require recency verification
BMI > 25 kg/m² uses current weight; do not use ideal body weight
The score is designed for cumulative risk — factor selection is not mutually exclusive
Next Steps
Clinical Actions
01
Calculate total Caprini Score by summing all applicable risk factor points
02
Determine VTE risk category (Very Low through High) using score thresholds
03
Select appropriate prophylaxis strategy based on risk category and bleeding risk assessment
04
For high-risk patients (score 5+): prescribe LMWH or fondaparinux; consider extended prophylaxis
05
Implement mechanical prophylaxis (SCDs) in addition to pharmacologic for highest-risk patients
06
Document risk assessment and prophylaxis plan in the medical record
07
Re-assess VTE risk post-operatively and at discharge if clinical status changes
The Evidence
Primary Reference
Thrombosis risk assessment as a guide to quality patient care
Caprini JA • Disease-a-Month. 2005;51(2-3):70-78 — Comprehensive description of the Caprini Risk Assessment Model
Validation Evidence
Validated in general surgery, orthopedics, urology, gynecology, and plastic surgery
C-statistic for VTE prediction: 0.70-0.80 across surgical populations
High-risk category (score 5+): OR 5.0-8.0 for VTE compared to very low risk
Implementation reduces symptomatic VTE rates by 30-60%
Recommended by ACCP, ASCCP, and multiple specialty society guidelines
Origins & History
Historical Background
The Caprini Risk Assessment Model was developed by Dr. Joseph A. Caprini, a vascular surgeon at NorthShore University HealthSystem and the University of Chicago. First published in the 1990s and refined in 2005, it has become the most widely used VTE risk assessment tool in surgical patients, endorsed by major surgical societies and regulatory bodies including the Joint Commission and CMS.
Last Comprehensive Review: 2026-07-17