MAGENT

Padua Prediction Score: the eleven items and how the points add up

The Padua Prediction Score adds weighted points for eleven items in a hospitalized medical patient: 3 points each for active cancer, previous VTE, reduced mobility and a known thrombophilic condition; 2 for recent trauma or surgery; and 1 each for age 70 or older, heart or respiratory failure, acute myocardial infarction or ischemic stroke, acute infection or rheumatologic disorder, obesity (BMI 30 or more) and ongoing hormone therapy. The maximum is 20. A 70-year-old with active cancer scores 3 + 1 = 4.

This page doesn't give a cutoff. Magent's calculator also returns a low/high group, but this page explains how the total is built, not what a total means or what to do with it.

Not a medical device. Not a diagnosis or dosing recommendation.

Use this calculator via API

What is the Padua Prediction Score?

The Padua Prediction Score is a risk assessment model for venous thromboembolism (VTE, blood clots in the veins) in hospitalized medical patients. It was published by S. Barbar, F. Noventa, P. Prandoni and colleagues in the Journal of Thrombosis and Haemostasis in 2010. It's also called the Padua score, the Padua VTE score or the Padua risk assessment model.

The 2010 abstract says the authors "sought to assess the value of a simple risk assessment model (RAM) for the identification of patients at risk of VTE."

This page explains each item and how the points add up. It doesn't say what a given total means, and the score doesn't diagnose a blood clot.

The Padua formula

Padua = 3 × active_cancer
      + 3 × previous_vte
      + 3 × reduced_mobility
      + 3 × thrombophilic_condition
      + 2 × recent_trauma_or_surgery
      + (age >= 70 ? 1 : 0)
      + heart_or_respiratory_failure
      + acute_mi_or_ischemic_stroke
      + acute_infection_or_rheumatologic_disorder
      + obesity
      + ongoing_hormonal_treatment

Exact expression the calculator uses:

Padua = active_cancer (3) + previous_vte (3) + reduced_mobility (3) + thrombophilic_condition (3) + recent_trauma_or_surgery (2) + age>=70 (1) + heart_or_respiratory_failure (1) + acute_mi_or_ischemic_stroke (1) + acute_infection_or_rheumatologic_disorder (1) + obesity (1) + ongoing_hormonal_treatment (1); max 20; <4 low, >=4 high

Maximum: 20.

The eleven items

ItemInputPointsHow Magent's record describes it
Active canceractive_cancer3Local or distant metastases and/or chemotherapy or radiotherapy in the previous 6 months
Previous VTEprevious_vte3Excludes superficial vein thrombosis
Reduced mobilityreduced_mobility3Bedrest with bathroom privileges for 3 days or more
Known thrombophilic conditionthrombophilic_condition3As assigned by the caller
Recent trauma and/or surgeryrecent_trauma_or_surgery2Within 1 month
Age 70 or olderage (18–120)170 scores; 69 doesn't
Heart and/or respiratory failureheart_or_respiratory_failure1
Acute MI or ischemic strokeacute_mi_or_ischemic_stroke1
Acute infection and/or rheumatologic disorderacute_infection_or_rheumatologic_disorder1
Obesityobesity1BMI 30 or more, as a yes/no flag
Ongoing hormone therapyongoing_hormonal_treatment1

Every item except age is a true/false answer from the caller.

How to calculate the Padua score

  1. The 3-point items. Add 3 for each of active cancer, previous VTE, reduced mobility and a known thrombophilic condition.
  2. The 2-point item. Add 2 for trauma or surgery within the past month.
  3. Age. Add 1 at age 70 or older. 70 counts; 69 doesn't.
  4. The 1-point items. Add 1 each for heart or respiratory failure, acute MI or ischemic stroke, acute infection or rheumatologic disorder, obesity and ongoing hormone therapy.
  5. Add everything. The total is 0 to 20.

What the calculator returns

Magent's calculator returns the total, the maximum of 20, the age it used, a line for each item and a low/high group. This page doesn't interpret the group.

Worked examples

These use Magent's own expected values for the calculator. Unless stated, age is 50 and every yes/no item is false.

Example 1: nothing scores

  1. Age 50 isn't 70 or older → 0.
  2. All ten flags false → 0.
  3. Padua = 0 (of 20).

Example 2: age 69 vs 70

  1. Age 69 → 0: Padua = 0.
  2. Age 70 → 1: Padua = 1.

Example 3: one 3-point item

  1. Active cancer → 3.
  2. Padua = 3.

Example 4: recent trauma or surgery

  1. Recent trauma or surgery → 2.
  2. Padua = 2.

Example 5: active cancer at age 70

  1. Active cancer → 3.
  2. Age 70 → 1.
  3. Padua = 4.

Example 6: two 3-point items

  1. Active cancer → 3; previous VTE → 3.
  2. Padua = 6.

Padua reference values

These are Magent's expected values for the calculator, with age 50 and every item false unless stated. Nothing scores 0, and age 69 still scores 0; age 70 scores 1. Active cancer, previous VTE, reduced mobility and a thrombophilic condition each score 3. Recent trauma or surgery scores 2. Heart or respiratory failure, acute MI or ischemic stroke, acute infection or rheumatologic disorder, obesity and ongoing hormone therapy each score 1. Active cancer at age 70 scores 4, and active cancer with previous VTE scores 6.

History of the Padua Prediction Score

The score comes from S. Barbar, F. Noventa, V. Rossetto, A. Ferrari and colleagues, A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score, Journal of Thrombosis and Haemostasis, 2010 (volume 8, issue 11, pages 2450–2457).

The abstract describes "a prospective cohort study" in which "1180 consecutive patients admitted to a department of internal medicine in a 2-year period" were classified using "a predefined RAM." Patients "were followed-up for up to 90 days to assess the occurrence of symptomatic VTE complications."

The abstract doesn't list the item weights. They come from Magent's record and code.

When it's used

Magent's record describes the score as applying to hospitalized medical patients, as in the paper.

Where it's used

The study took place in "a department of internal medicine," per the abstract.

Who uses it

In the study, patients were classified with the model at admission to internal medicine, per the abstract.

Limits of the calculation

  • It adds eleven weighted items. It doesn't diagnose a blood clot.
  • It's the Barbar 2010 Padua score. It isn't Caprini, IMPROVE or Khorana.
  • Obesity is a yes/no flag for BMI 30 or more. Magent doesn't take height or weight.
  • Every item except age is the caller's call.
  • The calculator returns a group alongside the total. This page doesn't give a cutoff or say what any total means.

Clinical decisions belong to a qualified clinician who knows the patient.

  • Khorana score is for outpatients with cancer starting chemotherapy, using cancer site and blood counts. Padua is for hospitalized medical patients.
  • Wells DVT is a probability score for a suspected deep vein thrombosis, not a prediction for an inpatient without one.

Glossary

  • VTE: venous thromboembolism, a blood clot in a vein (deep vein thrombosis or pulmonary embolism).
  • Thrombophilic condition: an inherited or acquired tendency for the blood to clot.
  • Superficial vein thrombosis: a clot in a vein near the skin surface.
  • Rheumatologic disorder: a condition affecting joints, muscles or connective tissue, such as rheumatoid arthritis.
  • BMI: body mass index, weight in kilograms divided by height in meters squared.
  • RAM: risk assessment model.

Common mistakes

  • Giving every item 1 point. Four items are worth 3 and one is worth 2.
  • Missing age 70. 70 or older scores; it isn't "over 70."
  • Counting superficial vein thrombosis as previous VTE. Magent's record excludes it.
  • Using it outside hospitalized medical patients. Magent's record limits it to that group, as in the paper.
  • Confusing it with Caprini. Magent's record says this calculator is the Padua score, not Caprini.

Source

Barbar S, Noventa F, Rossetto V, et al. 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):2450-2457. DOI: 10.1111/j.1538-7836.2010.04044.x

Frequently asked questions

How do you calculate the Padua score?

Add 3 each for active cancer, previous VTE, reduced mobility and thrombophilia; 2 for recent trauma or surgery; and 1 each for age 70 or older, heart or respiratory failure, acute MI or stroke, acute infection or rheumatologic disorder, obesity and hormone therapy. The maximum is 20.

What Padua score is high risk?

This page doesn't give a cutoff. It shows how the total is built.

Does age 70 score on the Padua score?

Yes. The item is age 70 or older.

Which Padua items are worth 3 points?

Active cancer, previous VTE, reduced mobility and a known thrombophilic condition.

Who developed the Padua Prediction Score?

S. Barbar and colleagues, in a 2010 paper in the Journal of Thrombosis and Haemostasis.