Related | Appendix B. VTE Risk Assessment - Caprini - Adult - Inpatient
Venous Thromboembolism Prophylaxis – Adult – Inpatient/Ambulatory
Appendix B. VTE Prophylaxis in Surgical Patients
Caprini Risk Assessment Model
1 Point 2 Points 3 Points 5 Points
Age 41-60 Age 61-74 Age ≥ 75 Acute spinal cord injury
(< 1 mo)
Acute MI (<1 mo) Central venous
access
Established
thrombophilia
Elective lower extremity
arthroplasty
BMI > 25 Immobile > 72 hrs HIT Hip, pelvis, or leg
fracture (< 1 mo)
CHF exacerbation
(<1 mo)
Leg plaster cast or
brace
Hx of VTE Stroke (< 1 mo)
Hx of Inflammatory
Bowel Disease
Malignancy Family hx VTE
(1 degree relative)
Procedure with local
anesthesia
Surgery- arthroscopic
Swollen legs or
Varicose veins
Surgery > 45 mins
Sepsis (< 1 mo)
Serious lung dx
ex. Pneumonia (<1 mo)
1 point
(For Women Only)
Oral contraceptives or HRT
Pregnancy or postpartum (< 1 month)
Hx of unexplained stillborn infant, spontaneous
abortion (≥3), premature birth with toxemia or
growth restricted infant
Points Risk Recommendation
0 Very Low VTE Risk Early and frequent ambulation
1-2 Low VTE Risk Mechanical Prophylaxis
3-4 Moderate VTE Risk and Low Bleed Risk Pharmacologic Prophylaxis
> 5 High VTE Risk and Low Bleed Risk Mechanical AND Pharmacologic Prophylaxis
> 2 High Bleed Risk Mechanical Prophylaxis
VTE Prophylaxis Regimens for High VTE Risk General Surgery Patients
Patient
Population
VTE Prophylaxis Regimens
Preferred Option Alternative Option
High VTE Risk Heparin 5000 units SQ every 8-12 hrsa Enoxaparin 40 mg SQ every 24 hrsa
Renal impairment
(CrCl < 30 mL/min)*
*Not on hemodialysis
Heparin 5000 units SQ every 8-12 hrsa Enoxaparin 30 mg SQ every 24 hrsb
Bariatric Surgery Enoxaparin 40 mg SQ every 12 hrsa Heparin 5000 units SQ every 8-12 hrsc
Major Trauma Enoxaparin 30 mg SQ every 12 hrsa Enoxaparin 0.5 mg/kg every 12 hrs
Heparin 5000 units SQ every 8-12 hrsc
Abdominal/Pelvic
Surgery for Cancer
Enoxaparin 40 mg SQ every 24 hrsb Heparin 5000 units SQ every 8-12 hrsc
Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: CCKM@uwhealth.org Last Revised: 03/2023
Effective 3/16/2023. Contact CCKM@uwhealth.org for previous versions
High Bleed Risk Intermittent pneumatic compression
devices (IPC)a
Graduated compression stockings
(GCS) or Venous foot pumps (VFP)c
Cardiac Surgery Heparin 5000 units SQ every 8-12 hrs Enoxaparin 40 mg SQ every 24 hrs
Craniotomy Intermittent pneumatic compression
devices (IPC)a
Graduated compression stockings
(GCS) or Venous foot pumps (VFP)c
Spinal Surgery Intermittent pneumatic compression
devices (IPC)a
Graduated compression stockings
(GCS) or Venous foot pumps (VFP)c
Thoracic Surgery Heparin 5000 units SQ every 8-12 hrs Enoxaparin 40 mg SQ every 24 hrs
Trauma Surgery Enoxaparin 30 mg every 12 hrsa Enoxaparin 0.5 mg/kg every 12 hrs
Heparin 5000 units SQ every 8-12 hrsc
a: UW Health GRADE Moderate quality evidence, strong recommendation
b: UW Health GRADE Low quality evidence, strong recommendation
c: UW Health GRADE Low quality evidence, weak/conditional recommendation
Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: CCKM@uwhealth.org Last Revised: 03/2023
Effective 3/16/2023. Contact CCKM@uwhealth.org for previous versions