Padua Score For VTE Risk

Stratifies in-hospital patients based on their venous thromboembolism risk factors.

You can read more about the score and the study it originates from, in the text below the tool.


This score is used in clinical settings as a risk stratification tool for in-hospital patients at risk of venous thromboembolism (VTE).

There are 11 variables that are analysed, ranging from previous VTE and thrombophilia to trauma and stroke.


The Padua scores of 4 and below indicate a high risk of VTE while scores below 4 indicate a low risk of VTE.

The score is based on a study from 2010, led by Barbar at University of Padua.

During a 2-year period 1,180 internal medicine patients have been classed as either at high or low risk of VTE.

The follow up consultation after 3 months assessed the occurrence of any VTE complications.


1Active cancer
2Previous VTE
3Decreased mobility
4Thrombophilia
5Previous trauma or surgery within that last 4 weeks
6Age ≥70
7Heart and/or respiratory failure
8Ischemic stroke or acute myocardial infarction
9Acute rheumatologic disorder and/or acute infection
10Obesity
11Hormonal therapy
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The Padua Score

As a health tool that evaluates risk of venous thromboembolism (VTE), the Padua score consists in 11 variables which double as risk factors.

The score evaluates in-hospital patients who may exhibit a number of factors.

This is a first step towards risk stratification and the result can inform further investigations and prophylactic treatment.

The following table introduces the 11 items, the points awarded to them in case they are present:

Padua items Points awarded
Active cancer 3
Previous VTE 3
Decreased mobility 3
Thrombophilia 3
Previous trauma or surgery within that last 4 weeks 2
Age ≥70 1
Heart and/or respiratory failure 1
Ischemic stroke or acute myocardial infarction 1
Acute rheumatologic disorder and/or acute infection 1
Obesity 1
Hormonal therapy 1
 

Padua score interpretation

The final score is determined by adding the number of points awarded to each item that is present in the evaluation of the patient.

Padua scores range from 0 (with no positive answers) to 20, where all items are described as present.

There is a cut off at 4, whereby any scores of 4 and above indicate a high risk for VTE and subsequent complications.

In this case patients are recommended thromboprophylaxis. Scores below 4 are considered low risk.

 

About the study

The study that has been conducted at the University of Padua was aimed at creating a method to increase prophylaxis amongst hospitalized medical patients at risk of venous thromboembolism (VTE).

During a 2-year period 1,180 internal medicine patients have been scored as either at high or low risk of VTE.

They underwent a follow up consultation after 3 months that assessed the occurrence of VTE complications.

The patients admitted in the study were supposed not to be on  full-dose anticoagulant therapy and have no contraindication to taking pharmacological prophylaxis.

They were excluded if they presented any of the following recent or ongoing major bleeding, creatinine clearance lower than 30 mL/min or platelet count lower than 100 × 109 L.

Out of the 469 patients classified as high risk, 186 have received thromboprophylaxis, amongst which only 4 developed VTE.

From the other 283 that have not received any prophylactic treatments, 31 developed VTE.

The method is criticised for the lack of validation studies and the fact that is not yet largely included in clinical usage to increase prophylaxis.

Dr Sofia Barbar is a physician at Civic Hospital of Cittadella in Padua, Italy. Her research is in venous thromboembolism (VTE) prevention.

 

Original study

Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M, De Bon E, Tormene D, Pagnan A, Prandoni P. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost. 2010; 8(11):2450-7.

Other references

1. Nendaz M, Spirk D, Kucher N, Aujesky D, Hayoz D, Beer JH, Husmann M, Frauchiger B, Korte W, Wuillemin WA, Jäger K, Righini M, Bounameaux H. Multicentre validation of the Geneva Risk Score for hospitalised medical patients at risk of venous thromboembolism. Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE). Thromb Haemost. 2014; 111(3):531-8.

2. Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med. 2005; 352(10):969-77.


App Version: 1.0.1

Coded By: MDApp

Specialty: Preventive Medicine

Objective: Risk Stratification

Type: Score

No. Of Items: 11

Year Of Study: 2010

Article By: Denise Nedea

Published On: March 16, 2017 · 03:25 AM

Last Checked: March 16, 2017

Next Review: March 10, 2018