Interactive tool
Calculate Caprini's score
Select the age group and tick all the factors present. The calculator applies the version 2005, the one implemented by the ACCP guidelines and most widely validated.
Come si usa
Instructions for use
When it applies
The model is created and validated in the patient surgical: general, vascular, urological, gynecological, plastic and reconstructive, orthopedic surgery. For the patient doctor hospitalized the appropriate tool is the score di Padua o l'IMPROVE: applying Caprini to the internal medicine patient means using it outside the context in which it was derived.
Quando ripeterlo
- At the entrance, before the operation.
- After the surgery, adding the items that the operation made true: duration > 45 minutes, central venous access, immobilization, bed rest > 72 hours. The pre-operative score almost always underestimates the true risk.
- At any relevant clinical change during hospitalization (infection, surgical resumption, prolonged immobilization).
Clarifications on the criteria
- Età: the bands are mutually exclusive, the calculator applies only one.
- Major surgery: intervention lasting > 45 minutes; the item can be combined with laparoscopic or prolonged arthroscopic surgery only if they are distinct procedures.
- Neoplasia: present or past. The score does not distinguish between cancer in active treatment and remission, and is one of the recognized limitations of the model.
- Trombofilia: each single documented alteration is worth 3 points and the items can be cumulated (for example factor V Leiden + antiphospholipid antibodies = 6 points).
- Voci riservate alle donne: contraception or hormone replacement therapy, pregnancy or puerperium within the month, unfavorable obstetric history not otherwise explained.
- The 5 point entries (recent stroke, elective arthroplasty, hip, pelvis or leg fracture, acute spinal cord injury, polytrauma) alone bring the patient into the highest risk class.
Caprini estimates the risk trombotico. The decision on pharmacological prophylaxis arises from a comparison with the risk hemorrhagic of the individual patient and the individual operation: in neurosurgery, ophthalmology surgery or in the presence of active bleeding, mechanical prophylaxis may remain the only option even with high scores.
Riferimenti clinici
Guidelines and interpretation
| Score | Risk class | Risk of VTE without prophylaxis | Strategia raccomandata |
|---|---|---|---|
| 0 | Very low | < 0,5% | Early walking; no specific prophylaxis |
| 1 – 2 | Bass | ~1,5% | Mechanical prophylaxis (intermittent pneumatic compression or elastic compression stockings) |
| 3 – 4 | Moderate | ~3,0% | Pharmacological prophylaxis (LMWH or unfractionated heparin) or mechanical if the bleeding risk is high |
| 5 – 6 | High | ~6,0% | Pharmacological prophylaxis associated with mechanical prophylaxis |
| 7 – 8 | High | > 6% | Pharmacological + mechanical; evaluate the extended duration |
| ≥ 9 | Altissimo | ~10–20% | Farmacologica + meccanica, con prophylaxis extended to 30 days in abdominal-pelvic oncological surgery |
Duration of prophylaxis
- Moderate-high risk general surgery: prophylaxis for the entire hospital stay and until the resumption of independent walking, usually 7–10 days.
- Major abdominal or pelvic oncological surgery: extended prophylaxis a 4 weeks after discharge, with significant reduction in symptomatic VTE (ACCP and ESMO recommendation).
- Artroprotesi di anca: 28–35 days. Artroprotesi di ginocchio: at least 10–14 days, extendable to 35.
- Frattura di femore: 28–35 days.
- Bariatric surgery: durata individualizzata, con dosaggi adattati al peso.
Considerazioni sul dosaggio
In obese patients the standard dosage of enoxaparin 4000 IU/day can be insufficient: in more recommendations In recent years, an increase proportional to weight is adopted (for example 4000 IU every 12 hours or 6000 IU/day above 100–120 kg). In severe renal failure (clearance < 30 ml/min) the dose of LMWH should be reduced or unfractionated heparin should be preferred. The timing of the first administration with respect to the operation and any neuraxial anesthesia follows the SIAARTI/ESA recommendations on safety times.
Limiti riconosciuti
- The model was derived by consensus, not from multivariate analysis: the individual factor loadings are not derived from regression coefficients.
- The distribution of scores varies greatly between specialties: in plastic surgery the majority of patients are concentrated between 3 and 6, in prosthetic orthopedics almost all exceed 8. The decision-making thresholds must be calibrated to the context.
- La versione 2013 (Caprini modified) adds and redefines some items and is used above all in the orthopedic field; This calculator implements the 2005 version, the one implemented by the ACCP guidelines.
- A systematic review published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders (2022) documented considerable heterogeneity in the risk categories used in the literature: when citing a score it is appropriate to also indicate which threshold scheme was adopted.
Bibliografia
Sources
- Caprini JA., Dis Mon 2005 — Thrombosis risk assessment as a guide to quality patient care.
- Gould MK. et al., Chest 2012 (ACCP 9th ed.) — Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis.
- Bahl V. et al., Ann Surg 2010 — A validation study of a retrospective venous thromboembolism risk scoring method.
- Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2022 — Systematic review of venous thromboembolism risk categories derived from Caprini score.
Quick consultation tool intended for healthcare personnel. It does not replace the original guidelines, the drug data sheets or the clinical judgment of the specialist. All calculations take place in the browser: no patient data is transmitted or stored on the server.