Question 1

Which patients qualify for extended-duration VTE prophylaxis?

Accepted Answer

Extended prophylaxis (up to 35 days) is recommended for very-high-risk surgical patients, particularly major cancer surgery with Caprini ≥7 and major orthopaedic surgery (total hip/knee arthroplasty, hip fracture surgery).

Question 2

Can Caprini be used in medical patients?

Accepted Answer

The Caprini score was developed and validated primarily in surgical populations. For medical patients, the Padua Prediction Score or IMPROVE score are more appropriate alternatives recommended by ACCP and ASH.

Question 3

How does obesity affect the Caprini score?

Accepted Answer

BMI >25 kg/m² scores 1 point, and BMI >40 is not separately captured. However, severe obesity independently increases VTE risk, and some experts suggest that patients with BMI >40 should be considered for the moderate-risk category even if their total score is low.

Question 4

Should I use Caprini or the Rogers score?

Accepted Answer

Caprini has been more extensively validated across surgical specialties. The Rogers score was developed specifically for general/vascular surgery from the NSQIP database. Both perform adequately; Caprini is more commonly used internationally.