Caprini Score
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| Each Risk Factor Represents 1 Point | |
| Age 41-60 years | |
| Minor surgery planned | |
| History of prior major surgery (<1 month) | |
| Varicose veins | |
| History of inflammatory bowel disease | |
| Swollen legs (current) | |
| Obesity (BMI > 25) | |
| Acute myocardial infarction | |
| Congestive heart failure (< 1 month) | |
| Sepsis (<1 month) | |
| Serious lung disease incl. pneumonia (<1 month) | |
| Abnormal pulmonary function (COPD) | |
| Medical patient currently at bed rest | |
| Orther risk factors ____________________ |
| Each Risk Factor Represents 2 Points | |
| Age 60-74 years | |
| Arthroscopic surgery | |
| Malignancy (present or previous) | |
| Major surgery (>45 minutes) | |
| Laparoscopic surgery (>45 minutes) | |
| Patient confined to bed (>72 hours) | |
| Immobilizing plaster cast (<1 month) | |
| Central Venous Catheter |
| Each Risk Factor Represents 5 Points | |
| Elective major lower extremity arthroplasty | |
| Hip, pelvis or leg fracture (<1 month) | |
| Stroke (<1 month) | |
| Multiple trauma (<1 month) | |
| Acute spinal cord injury (paralysis) (< 1 month) |
| Age over 75 years | |
| History of DVT/PE | |
| Family history of thrombosis * | |
| Positive Factor V Leiden | |
| Positive Prothrombin 20210A | |
| Elevated serum homocysteine | |
| Positive lupus anticoagulant | |
| Elevated anticardiolipin antibodies | |
| Heparin-induced thrombocytopenia (HIT) | |
| Other congenital or acquired thrombophilia If Yes: _______________________________ |
|
| * most frequently missed risk factor |
| For Women Only (Each Represents 1 Point) | |
| Oral contraceptives or hormone replacement therapy | |
| Pregnancy or postpartum (<1 month) | |
| History of unexplained stillborn infant, recurrent spontaneous abortion (≥3), premature birth with toxemia or growth- restricting infant |
Total Risk Factor Score ___________