Risk of Deep Venous Thrombosis and Pulmonary Embolism in Surgical Patients
Risk Category | Approximate Risk of DVT/PE (%) | Caprini Score | Rogers Score | Examples | Preventive Measures |
|---|---|---|---|---|---|
Very Low | < 0.5 | 0 | < 7 | Minor procedures (< 30–45 minutes) in patients < 40 years with no risk factors | No mechanical or pharmacologic prophylaxis |
Low | 1.5 | 1–2 | 7–10 | Major surgery (>45 minutes) in patients < 40 years Patients 40–74 years with no other risk factors Pregnant or postpartum patients | IPC |
Moderate | 3 | 3–4 | > 10 | Patients ≥ 75 years with no other risk factors Family history of VTE Known thrombophilia Major surgery in patients < 40 years with no other clinical risk factors | LMWH, LDUH, or IPC |
High | 6 | ≥ 5 | — | Major orthopedic surgery (arthroplasty, hip or pelvis fracture)> Acute spinal cord injury Multiple risk factors | LMWH or LDUH, and IPC Extended LMWH after abdominal/pelvic surgery for cancer IPC if high bleeding risk; aspirin + fondaparinux or IPC if heparin contraindicatedIPC if high bleeding risk; aspirin + fondaparinux or IPC if heparin contraindicated |
DVT = deep venous thrombosis; IPC = intermittent pneumatic compression; LDUH = low-dose unfractionated heparin; LMWH = low molecular weight heparin; PE = pulmonary embolism.DVT = deep venous thrombosis; IPC = intermittent pneumatic compression; LDUH = low-dose unfractionated heparin; LMWH = low molecular weight heparin; PE = pulmonary embolism. | |||||
Data from Gould MK, Garcia DA, Wren SM, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e227S-e277S. doi:10.1378/chest.11-2297Ada | |||||