Padua Score Calculator
Calculate padua score quickly with our cardiovascular system tool. Get results based on evidence-based formulas with clear explanations.
Formula
Padua Score = Sum of weighted risk factors (range 0-20)
Each risk factor is assigned a specific weight: Active cancer (3), Previous VTE (3), Reduced mobility (3), Known thrombophilia (3), Recent trauma/surgery (2), Age >= 75 (1), Heart/respiratory failure (1), Acute MI/stroke (1), Acute infection (1), Obesity BMI >= 30 (1), Hormonal therapy (1). Total score >= 4 indicates high risk for VTE.
Worked Examples
Example 1: High-Risk Medical Patient
Problem: A 78-year-old patient admitted with pneumonia has active cancer (on chemotherapy), reduced mobility (bed rest), and BMI of 33. Calculate the Padua Score.
Solution: Active cancer: +3 points\nReduced mobility (bed rest >= 3 days): +3 points\nAge >= 75 years: +1 point\nAcute infection (pneumonia): +1 point\nObesity (BMI >= 30): +1 point\n\nTotal Padua Score = 3 + 3 + 1 + 1 + 1 = 9 points
Result: Padua Score: 9 (High Risk) | VTE Risk: ~11% | Pharmacological prophylaxis recommended
Example 2: Low-Risk Medical Patient
Problem: A 55-year-old patient admitted with controlled diabetes has no immobility, no cancer history, and BMI of 27. Calculate the Padua Score.
Solution: No active cancer: 0 points\nNo previous VTE: 0 points\nNo reduced mobility: 0 points\nNo thrombophilia: 0 points\nNo recent trauma/surgery: 0 points\nAge < 75: 0 points\nNo heart/respiratory failure: 0 points\nNo acute MI/stroke: 0 points\nNo acute infection: 0 points\nNot obese: 0 points\nNo hormonal therapy: 0 points\n\nTotal Padua Score = 0 points
Result: Padua Score: 0 (Low Risk) | VTE Risk: ~0.3% | Routine prophylaxis not recommended
Frequently Asked Questions
What is the Padua Prediction Score and what does it assess?
The Padua Prediction Score is a validated risk assessment model developed in 2010 by Barbar and colleagues at the University of Padua, Italy, specifically designed to evaluate the risk of venous thromboembolism (VTE) in hospitalized medical patients. Unlike surgical risk assessment tools, the Padua Score addresses the unique thrombotic risk factors present in acutely ill medical patients. It assigns weighted points to 11 risk factors, with total scores ranging from 0 to 20. Patients scoring 4 or higher are classified as high risk with approximately 11% VTE incidence during hospitalization, while those scoring below 4 are classified as low risk with approximately 0.3% incidence. This stratification helps clinicians make evidence-based decisions about pharmacological thromboprophylaxis in medical inpatients.
How is the Padua Score different from other VTE risk assessment tools?
The Padua Score is specifically designed for medical inpatients, distinguishing it from surgical risk models like the Caprini Score. While surgical patients have well-established risk stratification based on procedure type and duration, medical patients present a more heterogeneous population requiring different risk factors. The Padua Score was validated in a prospective cohort study of 1,180 medical patients and demonstrated excellent discrimination between high-risk and low-risk groups. Other medical VTE risk tools include the IMPROVE score, which incorporates additional variables like D-dimer levels and lower extremity paralysis. The Geneva Risk Score is another alternative but was developed primarily for outpatients. Current ACCP and NICE guidelines recommend using validated risk assessment models like the Padua Score for medical patients.
What are the highest-weighted risk factors in the Padua Score?
Four risk factors in the Padua Score carry the maximum weight of 3 points each: active cancer, previous VTE, reduced mobility, and known thrombophilic condition. Active cancer includes patients with local or distant metastases, those who received chemotherapy or radiation therapy within the past 6 months, or those with cancer not in complete remission. Previous VTE encompasses any history of deep vein thrombosis or pulmonary embolism, as recurrence risk remains elevated. Reduced mobility is defined as anticipated bed rest with bathroom privileges for at least 3 days. Known thrombophilia includes conditions such as Factor V Leiden, prothrombin gene mutation, antithrombin deficiency, protein C or S deficiency, and antiphospholipid syndrome. Any single one of these high-weight factors combined with one additional point-bearing factor triggers high-risk classification.
What thromboprophylaxis is recommended for high-risk Padua Score patients?
Patients classified as high risk by the Padua Score (total score 4 or greater) should receive pharmacological thromboprophylaxis unless contraindicated. The recommended options include low-molecular-weight heparin (LMWH) such as enoxaparin 40 mg subcutaneously daily, unfractionated heparin (UFH) 5000 units subcutaneously every 8 or 12 hours, or fondaparinux 2.5 mg subcutaneously daily. LMWH is generally preferred due to once-daily dosing, more predictable pharmacokinetics, and lower risk of heparin-induced thrombocytopenia. Prophylaxis should be continued throughout the hospitalization and potentially beyond discharge in selected patients with persistent risk factors. Mechanical prophylaxis with graduated compression stockings or intermittent pneumatic compression devices should be used when pharmacological prophylaxis is contraindicated due to active bleeding or high bleeding risk.
How reliable is the Padua Score in different patient populations?
The Padua Score has been validated in several external cohorts with generally consistent performance, though some limitations exist. The original validation study in Italian medical patients showed excellent discrimination, with high-risk patients having a 37-fold greater VTE incidence than low-risk patients. Subsequent studies in different healthcare systems and populations have confirmed its clinical utility, though sensitivity and specificity vary. The score may underestimate risk in certain populations including critically ill ICU patients, patients with central venous catheters, and those with inflammatory bowel disease flares. It also does not account for some emerging risk factors such as COVID-19 infection, which dramatically increases VTE risk. In Asian populations, where baseline VTE incidence is lower than in Western populations, the Padua Score may overestimate absolute risk while maintaining its ability to discriminate between higher and lower risk groups.
How do I interpret the result?
Results are displayed with a label and unit to help you understand the output. Many calculators include a short explanation or classification below the result (for example, a BMI category or risk level). Refer to the worked examples section on this page for real-world context.