Padua Score Calculator

What is the Padua Prediction Score?

The Padua Prediction Score is an established, validated clinical risk assessment model designed to identify hospitalized medical (non-surgical) patients at high risk for Venous Thromboembolism (VTE), including Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Developed by Barbar et al. in 2010, the score stratifies patients into low-risk and high-risk cohorts to guide whether pharmacological thromboprophylaxis is indicated.

Scoring Criteria and Point Allocations

The Padua model evaluates 11 weighted clinical parameters. Each active criterion contributes points toward a cumulative score ranging from 0 to 20:

Risk Factor	Points	Clinical Definition / Criteria
Active cancer	+3	Local or distant metastases, or chemo/radiotherapy in the past 6 months.
Previous VTE	+3	Documented prior deep vein thrombosis or pulmonary embolism (excluding superficial).
Reduced mobility	+3	Bed rest with bathroom privileges for at least 3 consecutive days.
Known thrombophilia	+3	Antithrombin/protein C or S deficiency, factor V Leiden, prothrombin G20210A, or APS.
Recent trauma or surgery	+2	Major surgical intervention or trauma within the preceding 1 month.
Elderly age (≥ 70 years)	+1	Patient chronological age 70 years or older.
Heart or respiratory failure	+1	NYHA class III/IV heart failure or acute respiratory insufficiency.
Acute MI or ischemic stroke	+1	Acute myocardial infarction or acute cerebrovascular ischemia.
Acute infection / rheumatologic disorder	+1	Active sepsis, acute severe bacterial infection, or acute rheumatologic flare.
Obesity (BMI ≥ 30 kg/m²)	+1	Calculated body mass index of 30 or greater.
Ongoing hormonal therapy	+1	Systemic estrogen replacement or oral contraceptive therapy.

Risk Stratification and Prophylaxis Guidelines

Patients are classified into one of two clinical management categories based on their cumulative Padua score:

Low Risk (Score < 4)

VTE Incidence: ~0.3% without prophylaxis.

Pharmacological thromboprophylaxis is generally not recommended because the risk of anticoagulant-induced bleeding outweighs the low baseline thrombosis risk. Early ambulation is encouraged.

High Risk (Score ≥ 4)

VTE Incidence: ~11.0% without prophylaxis (reduced to ~2.2% with prophylaxis).

Pharmacological thromboprophylaxis (such as low-molecular-weight heparin, unfractionated heparin, or fondaparinux) is indicated and strongly recommended, provided no major bleeding contraindications exist.

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Frequently Asked Questions

Who should be evaluated with the Padua Prediction Score?

The Padua score is validated specifically for hospitalized medical (non-surgical) patients. Surgical patients are typically evaluated using surgical-specific risk models such as the Caprini score.

What score threshold indicates high risk for VTE?

A Padua score of 4 or higher indicates high risk for venous thromboembolism, carrying an estimated 11.0% VTE rate without thromboprophylaxis.

What defines reduced mobility in the Padua score?

Reduced mobility is defined as bed rest with bathroom privileges for at least 3 consecutive days due to patient physical limitations or clinical orders.

What are the recommended thromboprophylaxis options for high-risk patients?

Standard pharmacological options include low-dose unfractionated heparin (UFH), low-molecular-weight heparin (LMWH, such as enoxaparin), or fondaparinux, administered once bleeding contraindications are excluded.

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