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Appendix C. VTE Risk Assessment - Caprini - Adult - Inpatient

Appendix C. VTE Risk Assessment - Caprini - Adult - Inpatient - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Hematology and Coagulation, Related


Appendix D. Caprini Risk Assessment Model – Adult – Inpatient – Venous Thromboembolism
(VTE) Prophylaxis – CPG
Risk factors for venous thromboembolism (VTE) in the surgical patient
1 Point 2 Points 3 Points 5 Points
Age 41-60 years Age 61-74 years Age ≥ 75 Acute spinal cord injury
(< 1 month)
Acute MI (<1 month) Central venous access Established
thrombophilia*
Elective lower extremity
arthroplasty
BMI > 25 Immobile > 72 hours HIT Hip, pelvis, or leg fracture
(< 1 month)
CHF exacerbation (<1 month) Leg plaster cast or brace Hx of VTE Stroke (< 1 month)
Hx of inflammatory bowel
disease
Malignancy Family hx VTE
(1 degree relative)
Procedure with local
anesthesia
Surgery- arthroscopic
Swollen legs/ Varicose veins
(current)
Surgery > 45 mins
Sepsis (< 1 month)
Serious lung dx
ex. Pneumonia (<1 month)
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
VTE prophylaxis recommendations based on risk score
Points Risk Recommendation
0 Very Low VTE Risk Early and frequent ambulation
1-2 Low VTE Risk SCD
3-4 Moderate VTE Risk and Low Bleed Risk Enoxaparin or Heparin
> 5 High VTE Risk and Low Bleed Risk Enoxaparin or Heparin AND SCD
> 2 High Bleed Risk SCD
Patient
Population
VTE Prophylaxis Regimens
Preferred Option Alternative Option
High VTE Risk Heparin 5000 units SQ every 8-12 hrs Enoxaparin 40 mg SQ every 24 hrs
Renal impairment
(CrCl < 30 mL/min)*
*Not on hemodialysis
Heparin 5000 units SQ every 8-12 hrs Enoxaparin 30 mg SQ every 24 hrs
Bariatric Surgery Enoxaparin 40 mg SQ every 12 hrs Heparin 5000 units SQ every 8-12 hrs
Major Trauma Enoxaparin 30 mg SQ every 12 hrs Heparin 5000 units SQ every 8-12 hrs
Abdominal/Pelvic
Surgery for Cancer
Enoxaparin 40 mg SQ every 24 hrs Heparin 5000 units SQ every 8-12 hrs
High Bleed Risk Intermittent pneumatic compression
devices (IPC)
Graduated compression stockings
(GCS) or Venous foot pumps (VFP)
CPG Contact for Changes:
Name: Philip J Trapskin, PharmD, BCPS
Phone Number: 263-1328
Email Address: ptrapskin@uwhealth.org
Revised: 12/2016 Copyright © 2017 Univ ersity of Wisconsin Hospital s and Clinics Authority
Contact: Lee Vermeulen, CCKM @uwhealth.org Last Revised: 04/2017CCKM@uwhealth.org