Caprini score calculator (Caprini risk assessment model for VTE)
Score a surgical patient's risk of venous thromboembolism with the 2005 Caprini risk assessment model: pick the age band, tick every risk factor that applies, grouped by its 1, 2, 3 or 5 points, and see the total with its risk level from low to highest, the four levels Bahl and colleagues validated in 2010.
Guides
- Caprini score risk categories: what each band meansThe Caprini score risk categories explained: low, moderate, high and highest, the VTE rates in each, and how ACCP 2012 links them to prophylaxis.
How this Caprini score calculator works
This Caprini score calculator adds up the 2005 version of the Caprini risk assessment model, the Thrombosis Risk Factor Assessment form that Joseph Caprini published in Disease-a-Month in 2005 to estimate a surgical patient's risk of venous thromboembolism (VTE), meaning deep vein thrombosis (DVT) or pulmonary embolism (PE). The form has 40 tick boxes, three of them age bands and three for women only, and each box is worth 1, 2, 3 or 5 points. The clinician ticks every factor that applies and adds the points into a total risk factor score. One-point factors are common findings such as age 41 to 60, minor surgery, varicose veins or a BMI over 25. Two-point factors include major or laparoscopic surgery lasting more than 45 minutes, cancer and bed rest beyond 72 hours. Three-point factors are a personal or family history of thrombosis and the thrombophilias. Five-point factors are major lower extremity arthroplasty, hip, pelvis or leg fracture, stroke, multiple trauma and acute spinal cord injury.
Caprini score = sum of the points for every risk factor present (age 1–3, then 1, 2, 3 or 5 points per factor)
Risk level (Caprini 2005, Bahl 2010) = low 0–1, moderate 2, high 3–4, highest 5 or more
Caprini score chart: every item on the 2005 form by its points. Time limits such as "less than 1 month" are as printed on the form.
| Points | Risk factors |
|---|---|
| 1 each | Age 41–60; minor surgery planned; prior major surgery (less than 1 month); varicose veins; inflammatory bowel disease; swollen legs; BMI over 25; acute myocardial infarction; congestive heart failure (less than 1 month); sepsis (less than 1 month); serious lung disease including pneumonia (less than 1 month); abnormal pulmonary function (COPD); medical patient at bed rest; other risk factors |
| 1 each, women only | Oral contraceptives or hormone replacement therapy; pregnancy or postpartum (less than 1 month); unexplained stillborn infant, recurrent spontaneous abortion (3 or more), or premature birth with toxemia or a growth-restricted infant |
| 2 each | Age 61–74; arthroscopic surgery; malignancy (present or previous); major surgery (over 45 minutes); laparoscopic surgery (over 45 minutes); confined to bed (over 72 hours); immobilizing plaster cast (less than 1 month); central venous access |
| 3 each | Age 75 or over; history of DVT or PE; family history of thrombosis; factor V Leiden; prothrombin 20210A; elevated serum homocysteine; lupus anticoagulant; elevated anticardiolipin antibodies; heparin-induced thrombocytopenia; other congenital or acquired thrombophilia |
| 5 each | Elective major lower extremity arthroplasty; hip, pelvis or leg fracture (less than 1 month); stroke (less than 1 month); multiple trauma (less than 1 month); acute spinal cord injury with paralysis (less than 1 month) |
The 2005 form prints the age bands as 41–60, 60–74 and over 75, which overlap at 60 and leave out 75. This calculator uses 41–60, 61–74 and 75 or over, as the 2012 American College of Chest Physicians (ACCP) guideline reprints the model in its Table 7. Choose one age band, then tick every other factor that applies. Later revisions of the Caprini model changed some items and points; this page uses the 2005 form only.
Caprini score interpretation: what each risk level means
Caprini score interpretation rests on four risk levels set by the total: low at 0 to 1 point, moderate at 2, high at 3 to 4 and highest at 5 or more. Bahl and colleagues validated these levels in 2010 with a retrospective scoring method developed at the University of Michigan Health System, applied to 8,216 surgical inpatients from the National Surgical Quality Improvement Program and followed for 30 days after surgery. Venous thromboembolism occurred in 0% of the low level, 0.70% of the moderate level, 0.97% of the high level and 1.94% of the highest level, 1.4% overall, and risk level was significantly linked to VTE (odds ratio 1.9). Most patients sat near the top: 52.1% scored highest, 36.5% high, 10.4% moderate and 0.9% low. Because some patients received prophylaxis, these observed rates understate untreated risk. The 2012 ACCP guideline later regrouped the same Caprini score into very low, low, moderate and high risk, with an estimate of the risk without prophylaxis.
| Caprini score | Risk level (Caprini 2005) | VTE within 30 days (Bahl 2010) | ACCP 2012 category | Estimated risk without prophylaxis (ACCP 2012) |
|---|---|---|---|---|
| 0 | Low | 0% | Very low | Below 0.5% |
| 1 | Low | 0% | Low | About 1.5% |
| 2 | Moderate | 0.70% | Low | About 1.5% |
| 3–4 | High | 0.97% | Moderate | About 3.0% |
| 5 or more | Highest | 1.94% | High | About 6.0% |
ACCP's estimates without prophylaxis apply to general and abdominal-pelvic surgery. Above 5 points, risk keeps climbing. In 1,126 plastic and reconstructive surgery patients who received no chemoprophylaxis, Pannucci and colleagues found VTE within 60 days in 0.61% at 3–4 points, 1.27% at 5–6, 2.69% at 7–8 and 11.32% above 8. The guide to Caprini score risk categories explains each band and how ACCP 2012 links the categories to mechanical or pharmacological prophylaxis.
When the Caprini score is less reliable
The Caprini score is less reliable when risk factors go unrecorded or when it is applied outside the patients it was tested in. The 2012 ACCP guideline notes that the model was not developed with rigorous statistical methods and includes some variables later found not to be associated with VTE risk, though it is easy to use and appears to discriminate reasonably well among patients at low, moderate and high risk. Bahl's validation was retrospective, in general, vascular and urological surgery patients, and some received prophylaxis, so its rates understate untreated risk. The 2005 form itself flags family history of thrombosis as the most frequently missed risk factor, and thrombophilia test results are often unknown at the time of scoring, which lowers the total. The Caprini score does not measure bleeding risk, which also shapes prophylaxis decisions. It predicts future VTE and does not diagnose a clot that is already there: for a patient with a swollen, painful leg now, use the Wells score for DVT.
Questions
What is a high Caprini score?
In the 2005 model, 3 to 4 points is high risk and 5 or more is the highest risk level. ACCP 2012 calls 5 or more high risk, with an estimated VTE risk of about 6% without prophylaxis after general or abdominal-pelvic surgery.
Which version of the Caprini score is this?
The 2005 Thrombosis Risk Factor Assessment form from Caprini's Disease-a-Month paper, with the four risk levels validated by Bahl and colleagues in 2010. Later revisions changed some items and points and are not used here.
What is the difference between the Caprini score and the Wells score for DVT?
The Caprini score estimates the risk of a future DVT or PE, usually around surgery. The Wells score estimates how likely it is that a patient with symptoms has a DVT now. Use the Wells score for DVT calculator for suspected DVT.
Does the Caprini score say which prophylaxis to use?
The score gives a risk level; guidelines such as ACCP 2012 link each level to no prophylaxis, mechanical prophylaxis or pharmacological prophylaxis, weighed against bleeding risk. See the Caprini risk categories guide. This page gives no drugs or doses.
Is my data sent anywhere?
No. The calculation runs in your browser, and the boxes you tick are not sent or stored.
Sources
- Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2–3):70–78. doi:10.1016/j.disamonth.2005.02.003
- Bahl V, Hu HM, Henke PK, Wakefield TW, Campbell DA Jr, Caprini JA. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg. 2010;251(2):344–350. doi:10.1097/SLA.0b013e3181b7fca6
- Gould MK, Garcia DA, Wren SM, 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(2 Suppl):e227S–e277S. doi:10.1378/chest.11-2297
- Pannucci CJ, Bailey SH, Dreszer G, et al. Validation of the Caprini risk assessment model in plastic and reconstructive surgery patients. J Am Coll Surg. 2011;212(1):105–112. doi:10.1016/j.jamcollsurg.2010.08.018