Assessment Patients - Caprini Rsk Score

Only your doctor can determine if you are at risk for Deep Vein Thrombosis (DVT), a blood clot that forms in one of the deep veins of your legs.A review of your personal history and current health may determine if you are at risk for developing this condition. Please take a moment to complete this form for yourself (or complete it for a loved one). Then be sure to talk with your doctor about your risk for DVT and what you can do to help protect against it.

Indicate your Age.
(This field is required.) *

0 - 40 years old

41 - 60 years old

61 - 74 years old

Age 75 or older

Medical history
(Click each statement that applies.)

Within the last month, I had surgery under general or regional anesthesia.

Within the last month, I had or currently have varicose veins. (NOT spider veins)

Within the last month, I had or currently have swollen legs.

Within the last month, I had a heart attack.

Within the last month, I had or currently have a serious infection requiring hospitalization (for example pneumonia, cellulitis, etc.)

I have a history of inflammatory bowel disease (including Crohn’s or ulcerative colitis).

I have or have had congestive heart failure.

I have a chronic lung disease (for example COPD or emphysema) NOT including asthma.

Indicate your gender
(This field is required.) *

Female

Male

For women only
(click each statement that applies)

I currently use birth control (oral contraceptive pills, skin implantable devices, hormonal patches, IUD with hormones, depo shot) or hormone replacement therapy. Not including condoms or barrier devices.

I am pregnant or had a baby within the last month.

I have a history of an unexplained stillborn infant, THREE (3) or more spontaneous abortions, premature birth with preeclampsia, or a baby born smaller than appropriate (low weight at birth).

Current medical conditions
(Click each statement that applies)

I have been told that I have or have had cancer, leukemia, lymphoma, or melanoma.

In the last month, I had a non-removable plaster cast or mold that has kept me from bending and/or walking normally on this leg.

In the last month, I have had or currently have a PICC line, port, or central venous access catheter in my neck or chest that delivers blood or medicine directly into my heart.

Blood clot history
(Click each statement that applies)

I have had a blood clot in my legs, arms, abdomen, or lungs.

Somebody in my family (Blood relatives including parents, grandparents, aunts, uncles, siblings, cousins) has suffered from a blood clot.

A blood relative or I had an abnormal blood test indicating an increased risk of blood clotting.

Mobility
(Click each statement that applies)

I have been in bed for LESS than THREE (3) DAYS associated with sustained walking of fewer than 30 feet.

I have been in bed for THREE (3) or MORE DAYS associated with sustained walking of fewer than 30 feet.

Severe medical complications within the past month
(Click each statement that applies)

I broke a hip, pelvis, or leg.

I had a severe trauma (for example, multiple broken bones due to a fall or accident).

I had a stroke (clot or hemorrhage in the brain, transient ischemic attack).

I had a spinal cord injury with paralysis.

Scheduled Surgery
(Click each statement that applies)

I have a scheduled surgery under general or regional anesthesia for LESS THAN 45 minutes.

I have a scheduled surgery under general or regional anesthesia for MORE THAN 45 minutes (including laparoscopic or arthroscopic procedures but excluding joint replacement).

I have a joint replacement surgery scheduled.

Body Mass Index (BMI)
(This field is required.) *

Weight (lb)

Height

BMI

BMI >25 (I Point)

This factor was derived from several sources including criteria associated with readmission following total

Joint replacement

Joint replacement: https://pubmed.ncbi.nlm.nih.gov/11114314/

Abstract

Background: Recent studies have shown that symptomatic venous thromboembolism after total hip arthroplasty most commonly develops after the patient is discharged from the hospital. Risk factors associated with these symptomatic thromboembolic events are not well defined.

Methods: Using administrative data from the California Medicare records for 1993 through 1996, we identified 297 patients 65 years of age or older who were rehospitalized for thromboembolism within three months after total hip arthroplasty. We compared demographic, surgical, and medical variables potentially associated with the development of thromboembolism in these patients and 592 unmatched controls.

Results: A total of 89.6 percent of patients with thromboembolism and 93.8 percent of control patients were treated with pneumatic compression, warfarin, enoxaparin, or unfractionated heparin, alone or in combination. In addition, 22.2 percent and 29.7 percent, respectively, received warfarin after discharge. A body-mass index (the weight in kilograms divided by the square of the height in meters) of 25 or greater was associated with rehospitalization for thromboembolism, with an odds ratio of 2.5 (95 percent confidence interval, 1.8 to 3.4). In a multivariate model, the only prophylactic regimens associated with a reduced risk of thromboembolism were pneumatic compression in patients with body-mass indexes of less than 25 (odds ratio, 0.3; 95 percent confidence interval, 0.2 to 0.6) and warfarin treatment after discharge (odds ratio, 0.6; 95 percent confidence interval, 0.4 to 1.0).

Conclusions: In patients who underwent total hip arthroplasty, a body-mass index of 25 or greater was associated with subsequent hospitalization for thromboembolism. Pneumatic compression in patients with a body-mass index of less than 25 and prophylaxis with warfarin after discharge were independently protective against thromboembolism.

, and in patients taking birth control

Pills

Pills: https://pubmed.ncbi.nlm.nih.gov/12624633/

Abstract

Deep vein thrombosis (DVT) is a common disease with an annual incidence of about 1 in 1000. Many risk factors have already been studied, both genetic and acquired. It is unclear whether obesity affects thrombotic risk in unselected patients. Obesity is common, with a prevalence of 20-25% and may therefore have a considerable impact on the overall incidence of thrombosis. We evaluated the risk of thrombosis due to overweight and obesity using data from a large population-based case-control study. Four hundred and fifty-four consecutive patients with a first episode of objectively diagnosed thrombosis from three Anticoagulation Clinics in the Netherlands were enrolled in a case-control study. Controls were matched on age and sex to patients and were introduced by the patients. All patients completed a standard questionnaire and interview, with weight and height measured under standard conditions. The associations of obesity with clotting factor levels were studied to investigate possible mechanisms. Obesity (BMI >/=30 kg/m(2)) increased the risk of thrombosis twofold (CI95: 1.5 to 3.4), adjusted for age and sex. Obese individuals had higher levels of factor VIII and factor IX, but not of fibrinogen. The effect on risk of obesity was not changed after adjustment for coagulation factors levels (fibrinogen, F VIII, F IX, D-dimer). The relative risk estimates were similar in different age groups and in both sexes, indicating a larger absolute effect in older age groups. Evaluation of the combined effect of obesity and oral contraceptive pills among women aged 15-45 revealed that oral contraceptives further increased the effect of obesity on the risk of thrombosis, leading to 10-fold increased risk amongst women with a BMI greater than 25 kg/m(2) who used oral contraceptives. Obesity is a risk factor for deep vein thrombosis. Among women with a BMI greater than 25 kg/m(2) the synergistic effect with oral contraceptives should be considered when prescribing these.

Additional Risk Factors
(Click each statement that applies)

Smoking

Diabetes requiring insulin

Chemotherapy

Blood transfusion

Human immunodeficiency virus (HIV)

Know your Risk for Blood Clots & Save Your Life

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