Padua Prediction Score (VTE risk in hospitalized medical patients)
VTE risk stratification for medical inpatients. A total of ≥ 4 points indicates the need for anticoagulant prophylaxis.
About this calculator
The Padua score assesses VTE risk in hospitalized medical (non-surgical) patients. Developed by Barbar et al. (J Thromb Haemost, 2010) in 1180 patients. Eleven criteria weighted 1-3 points: active cancer (3), prior VTE (3), reduced mobility >=3 days (3), thrombophilia (3), recent trauma/surgery <=1 month (2), age >=70 (1), heart/respiratory failure (1), MI or ischemic stroke (1), acute infection/rheumatic disease (1), obesity BMI >=30 (1), hormonal therapy (1). Maximum 17. Interpretation. <4 – low VTE risk <0.3%, no prophylaxis. >=4 – high risk 11%, prophylaxis with LMWH (enoxaparin 40 mg once daily) or DOAC for the entire admission. Clinical use. ACCP CHEST 2012 (updated 2020) and ASH 2018 – primary stratification tool in general medicine, geriatrics, infectious diseases. Padua is specifically validated for non-surgical hospitalized patients, in contrast to Caprini (surgical). In COVID-19 patients adapted versions of Padua are used, with D-dimer and pneumonia severity adjustments. Prophylaxis contraindications. Active major bleeding. Platelets <50×10⁹/L. BMI <18.5. Creatinine >265 µmol/L (use UFH or adjust LMWH). Spinal/epidural anesthesia within 12 hours (LMWH) or 4 hours (UFH). With contraindications – mechanical prophylaxis (compression stockings, intermittent compression). Limitations. Does not capture COVID-19 and pandemic factors (validation predated 2020). Does not separate DVT vs PE risk. Post-discharge risk persists – some patients with Padua >=4 at discharge may benefit from extended thromboprophylaxis for 6-39 days (MAGELLAN, MARINER).
Source
Formula version: barbar-2010-ash-2018-v1