Padua Prediction Score Calculator for VTE Risk
Calculate the source-exact 11-item Padua Prediction Score for hospitalized medical patients, with explicit definitions, a full point audit, and bleeding-risk limitations.
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About
This Padua Prediction Score calculator reproduces the Barbar 2010 11-item model for adults hospitalized in internal medicine. Every criterion must be answered; an unanswered item never becomes zero silently. [1]
The original prospective single-center cohort recruited 1,180 adults during 2007–2008 and followed them for up to 90 days. It had 37 symptomatic VTE events and important protocol exclusions, so the source categories are not universal patient probabilities. [1, 5]
Formula
Interpretation
| Score | Original Padua category | What this page does |
|---|---|---|
| 0–3 | Low VTE risk | Reports the historical source category; does not declare prophylaxis unnecessary. |
| ≥4 | High VTE risk | Reports the historical source category; does not prescribe prophylaxis. |
The exact boundary is 3 = low and 4 = high. No additional severity bands are added. [1]
Historical cohort outcomes—not your probability
The original cohort classified 469/1,180 patients as high risk and 711/1,180 as low risk. Symptomatic VTE occurred in 31/283 high-risk patients without prophylaxis (11.0%), 4/186 high-risk patients who received prophylaxis (2.2%), and 2/711 low-risk patients (0.3%); the reported high-risk/no-prophylaxis versus low-risk hazard ratio was 32.0 (95% CI 4.1–251.0). These are historical study-group observations, not an individualized forecast. [1]
Padua is not a complete prophylaxis decision
Padua does not assess bleeding risk, contraindications, renal dosing, platelet count, active bleeding, medication interactions, or another indication for anticoagulation. ASH identifies Padua and IMPROVE as studied RAMs while emphasizing individualized VTE and bleeding-risk assessment; its 2018 medical-patient guideline remains under current monitoring. NICE likewise calls for both VTE and bleeding-risk assessment and reassessment as clinical condition changes. [3, 4, 6]
Padua versus Wells, PERC, Caprini, and IMPROVE
- Padua: future VTE-risk stratification in hospitalized medical patients.
- Wells DVT / Wells PE: separate pretest-probability frameworks for suspected DVT or PE.
- PERC: conditional PE rule-out criteria after low pretest probability has independently been established.
- Caprini: a separate, primarily surgical/perioperative VTE RAM.
- IMPROVE VTE / IMPROVE Bleeding: separate hospitalized-medical VTE and bleeding-risk RAMs. No score conversion is valid.
Population and exclusions
The development study concerned hospitalized internal-medicine adults, not surgical, pregnancy, outpatient, or suspected-clot diagnostic populations. Historical exclusions included pregnancy, current full-dose anticoagulation or an existing indication for therapeutic anticoagulation, and study-protocol contraindications to pharmacologic prophylaxis, including specified bleeding, platelet, and renal exclusions. These describe the study—not an automated modern eligibility rule. [1, 2]
References
- 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. PMID 20738765. DOI 10.1111/j.1538-7836.2010.04044.x.
- Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. Chest. 2012;141(2 Suppl):e195S–e226S. PMID 22315261. PMCID PMC3278052. DOI 10.1378/chest.11-2296.
- Schünemann HJ, Cushman M, Burnett AE, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv. 2018;2(22):3198–3225. PMID 30482763. PMCID PMC6258910. DOI 10.1182/bloodadvances.2018022954.
- American Society of Hematology. VTE Guidelines: Prophylaxis for Hospitalized and Non-Hospitalized Medical Patients. Current guideline resource and monitoring status. Accessed September 9, 2026.
- Darzi AJ, Karam SG, Spencer FA, et al. Risk-assessment models for VTE and bleeding in hospitalized medical patients: an overview of systematic reviews. Blood Adv. 2020;4(19):4929–4944. PMID 33049056. PMCID PMC7556144. DOI 10.1182/bloodadvances.2020002482.
- National Institute for Health and Care Excellence. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89). Updated August 13, 2019; evidence reviewed September 2024 with no update required.
FAQ
The Padua Prediction Score is an 11-item weighted VTE risk-assessment model developed for adults hospitalized in an internal-medicine department. It stratifies the historical source cohort at a total below 4 versus 4 or higher; it does not diagnose DVT or PE.
Sources: [1]
The original definition is anticipated bed rest with bathroom privileges, because of the patient's limitations or a physician order, for at least 3 days. It should not be replaced with the different IMPROVE immobilization definition.
Sources: [1]
Active cancer means local or distant metastases and/or chemotherapy or radiotherapy in the previous 6 months. Previous DVT or PE counts, while superficial vein thrombosis is excluded. Known thrombophilia includes established antithrombin, protein C, or protein S deficiency, factor V Leiden, prothrombin G20210A mutation, or antiphospholipid syndrome; it is not inferred from family history alone.
Sources: [1]
The maximum is 20: four 3-point criteria, one 2-point criterion, and six 1-point criteria. Every item must be answered explicitly because missing information cannot silently contribute zero.
Sources: [1]
Padua stratifies future VTE risk in hospitalized medical patients. Wells DVT and Wells PE are separate pretest-probability frameworks for suspected DVT or PE, and PERC is a conditional PE rule-out framework after low pretest probability is independently established. Their scores are not interchangeable.
No. Padua does not assess bleeding, contraindications, renal dosing, platelet count, active bleeding, medication interactions, or another indication for anticoagulation. Current guidance considers VTE and bleeding risk together rather than treating Padua as a complete prophylaxis decision.
No. A score of 4 or higher reproduces the original high-risk category only. Current decisions require separate assessment of bleeding risk, contraindications, changing clinical condition, local guidance, and individual context; this calculator selects no medicine, dose, route, or duration.
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PERC Rule
Check all eight PERC criteria for a low-probability adult suspected-PE assessment, with exact age, pulse, room-air oxygen, history, and examination boundaries.
Disclaimer
Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.