The Thresholds of Caprini Score Associated With Increased Risk of Venous Thromboembolism Across Different Specialties: A Systematic Review

Ann Surg. 2023 Mar 13. doi: 10.1097/SLA.0000000000005843. Online ahead of print.


Objective: Estimation of the specific thresholds of the Caprini risk score (CRS) that are associated with the increased incidence of venous thromboembolism (VTE) across different specialties, including identifying the highest level of risk.

Background: Accurate risk assessment remains an important but often challenging aspect of VTE prophylaxis. One well-established risk assessment model is CRS, which has been validated in thousands of patients from many different medical and surgical specialties.

Methods: A search of MEDLINE and the Cochrane Library was performed in March 2022. Manuscripts that reported on 1) patients admitted to medical or surgical departments and 2) had their VTE risk assessed by CRS and 3) reported on the correlation between the score and VTE incidence, were included in the analysis.

Results: A total of 4562 references were identified, and the full text of 202 papers was assessed for eligibility. The correlation between CRS and VTE incidence was reported in 68 studies that enrolled 4,207,895 patients. In all specialties, a significant increase in VTE incidence was observed in patients with a CRS of ≥5. In most specialties thresholds of ≥7, ≥9, and ≥11-12 were associated with dramatically increased incidences of VTE. In COVID-19, cancer, trauma, vascular, general, head and neck, and thoracic surgery patients with ≥9 and ≥11-12 scores the VTE incidence was extremely high (ranging from 13% to 47%).

Conclusion: The Caprini score is being used increasingly to predict VTE in many medical and surgical specialties. In most cases the VTE risk for individual patients increases dramatically at a threshold CRS of 7-11.