Padua Score Calculator

Comprehensive venous thromboembolism (VTE) risk assessment for hospitalized medical patients.

Calculate your Padua Score based on age, obesity, previous VTE, cancer, reduced mobility, recent trauma/surgery, heart/respiratory failure, acute MI/ischemic stroke, acute infection/rheumatologic disorder, hormonal treatment, and thrombophilia. Receive personalized VTE risk assessment and thromboprophylaxis recommendations.

Example Cases

Explore different clinical scenarios and their Padua Score calculations

Low Risk Patient

Low Risk

A relatively healthy patient with minimal VTE risk factors requiring standard care.

Age ≥70: No

Obesity (BMI ≥30): No

Previous VTE: No

Active Cancer: No

Reduced Mobility: No

Recent Trauma/Surgery: No

Heart/Respiratory Failure: No

Acute MI/Stroke: No

Acute Infection/Rheumatologic: No

Hormonal Treatment: No

Known Thrombophilia: No

Moderate Risk Patient

Moderate Risk

A patient with several VTE risk factors requiring careful monitoring and consideration of thromboprophylaxis.

Age ≥70: Yes

Obesity (BMI ≥30): Yes

Previous VTE: No

Active Cancer: No

Reduced Mobility: Yes

Recent Trauma/Surgery: No

Heart/Respiratory Failure: No

Acute MI/Stroke: No

Acute Infection/Rheumatologic: No

Hormonal Treatment: No

Known Thrombophilia: No

High Risk Patient

High Risk

A patient with multiple major VTE risk factors requiring aggressive thromboprophylaxis.

Age ≥70: Yes

Obesity (BMI ≥30): Yes

Previous VTE: Yes

Active Cancer: Yes

Reduced Mobility: Yes

Recent Trauma/Surgery: No

Heart/Respiratory Failure: No

Acute MI/Stroke: No

Acute Infection/Rheumatologic: No

Hormonal Treatment: No

Known Thrombophilia: No

Very High Risk Patient

Very High Risk

A patient with extensive VTE risk factors requiring immediate and aggressive thromboprophylaxis.

Age ≥70: Yes

Obesity (BMI ≥30): Yes

Previous VTE: Yes

Active Cancer: Yes

Reduced Mobility: Yes

Recent Trauma/Surgery: Yes

Heart/Respiratory Failure: Yes

Acute MI/Stroke: No

Acute Infection/Rheumatologic: Yes

Hormonal Treatment: Yes

Known Thrombophilia: Yes

Other Titles
Understanding the Padua Score: A Comprehensive Guide
Learn about venous thromboembolism risk assessment and the Padua Score calculation methodology

What is the Padua Score?

  • Definition and Purpose
  • Clinical Validation
  • International Guidelines
The Padua Score is a validated risk assessment tool designed to predict the risk of venous thromboembolism (VTE) in hospitalized medical patients. Developed at the University of Padua in Italy, this scoring system helps healthcare providers identify patients who would benefit from thromboprophylaxis to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). The score incorporates 11 clinical variables that have been shown to independently predict VTE risk in medical patients.
Clinical Validation and Evidence Base
The Padua Score has been extensively validated in multiple studies involving thousands of medical patients. The original validation study demonstrated excellent discrimination with an area under the receiver operating characteristic curve (AUC) of 0.75. Subsequent studies have confirmed the score's predictive accuracy across different populations and healthcare settings. The score has been incorporated into international guidelines including those from the American College of Chest Physicians (ACCP) and the European Society of Cardiology (ESC).
Integration with Clinical Guidelines
The Padua Score is recommended by major clinical guidelines for VTE risk assessment in medical patients. The ACCP guidelines suggest using validated risk assessment tools like the Padua Score to guide thromboprophylaxis decisions. The score helps standardize VTE risk assessment across different healthcare settings and ensures that high-risk patients receive appropriate prophylaxis while avoiding unnecessary treatment in low-risk patients.

Key Features of the Padua Score:

  • Validated in multiple clinical studies with thousands of patients
  • Incorporates 11 independent VTE risk factors
  • Provides clear risk stratification (low vs. high risk)
  • Guides evidence-based thromboprophylaxis decisions

Step-by-Step Guide to Using the Padua Score Calculator

  • Patient Assessment Protocol
  • Risk Factor Documentation
  • Score Calculation and Interpretation
Accurate Padua Score calculation requires systematic patient assessment, careful documentation of risk factors, and proper interpretation of results. Follow this comprehensive methodology to ensure reliable VTE risk stratification and appropriate thromboprophylaxis recommendations.
1. Comprehensive Patient History and Assessment
Begin with a thorough patient history focusing on VTE risk factors. Document the patient's exact age, as age ≥70 years confers 1 point in the scoring system. Assess body mass index (BMI) through measurement or documented values, with BMI ≥30 kg/m² scoring 1 point. Obtain detailed history of previous VTE events, including timing, location, and treatment received. Previous VTE is a major risk factor scoring 3 points. Evaluate for active cancer or cancer treatment within the past 6 months, which scores 3 points.
2. Mobility and Functional Status Assessment
Assess the patient's mobility status, as reduced mobility for ≥3 days scores 3 points. This includes bed rest, chair confinement, or significant mobility limitations. Evaluate for recent trauma or surgery within the past month, which scores 2 points. Document the type and severity of trauma or surgery, as these factors activate the coagulation cascade and reduce mobility. Assess for acute heart failure or acute respiratory failure, which scores 1 point each.
3. Acute Medical Conditions and Treatments
Document acute myocardial infarction or acute ischemic stroke, which scores 1 point each. These conditions increase VTE risk through immobility and inflammatory response. Assess for acute infection or acute rheumatologic disorder, which scores 1 point. Evaluate current hormonal treatments including oral contraceptives, hormone replacement therapy, or testosterone therapy, which scores 1 point. Document known thrombophilia including factor V Leiden, prothrombin gene mutation, or antiphospholipid syndrome, which scores 3 points.
4. Score Calculation and Risk Stratification
Sum all applicable points to obtain the total Padua Score. Scores range from 0 to 20, with each point representing increased VTE risk. Interpret the score according to established guidelines: scores <4 indicate low risk, while scores ≥4 indicate high risk requiring thromboprophylaxis. Use the calculated VTE probability to guide patient counseling and treatment decisions. Consider individual patient factors and contraindications when making thromboprophylaxis recommendations.

Assessment Best Practices:

  • Document all risk factors with specific dates and diagnostic criteria
  • Use multiple sources to verify medical history accuracy
  • Consider temporal relationships between risk factors and hospitalization
  • Update assessment regularly as patient condition changes during hospitalization

Real-World Applications and Clinical Decision Making

  • Thromboprophylaxis Guidance
  • Patient Counseling and Education
  • Risk Factor Modification
The Padua Score calculator serves as a cornerstone for evidence-based VTE prevention in hospitalized medical patients, supporting critical clinical decisions about thromboprophylaxis, patient education, and risk factor modification strategies.
Thromboprophylaxis Decision Making
The Padua Score directly guides thromboprophylaxis decisions according to international guidelines. Patients with scores ≥4 are recommended for pharmacological thromboprophylaxis, typically with low-molecular-weight heparin (LMWH), unfractionated heparin, or direct oral anticoagulants (DOACs). The choice between specific agents considers renal function, bleeding risk, and patient preferences. For patients with scores <4, mechanical prophylaxis or no prophylaxis may be appropriate depending on individual circumstances.
Patient Counseling and Shared Decision Making
The calculated VTE probability provides concrete information for patient education and shared decision making. Patients can understand their individual risk and the potential benefits of thromboprophylaxis. Discuss both the absolute and relative risk reduction with prophylaxis, typically 50-70% reduction in VTE risk. Address common concerns including bleeding risk, injection discomfort, and medication adherence. Use visual aids and risk communication tools to enhance patient understanding and engagement in treatment decisions.
Risk Factor Modification and Prevention
Beyond thromboprophylaxis decisions, the Padua Score assessment identifies modifiable risk factors that can be targeted for intervention. Early mobilization and physical therapy can reduce immobility-related VTE risk. Weight management strategies can address obesity-related risk factors. Smoking cessation and management of other cardiovascular risk factors provide additional benefits. Regular reassessment allows monitoring of risk factor modification effectiveness and adjustment of prophylaxis strategies.

Clinical Decision Points by Score:

  • Score <4: Low risk, consider mechanical prophylaxis or no prophylaxis
  • Score ≥4: High risk, recommend pharmacological thromboprophylaxis
  • Score ≥6: Very high risk, consider extended prophylaxis duration
  • Score ≥8: Extremely high risk, aggressive prophylaxis and monitoring

Common Misconceptions and Correct Methods

  • Risk Factor Overestimation
  • Scoring Errors
  • Clinical Integration
Understanding common misconceptions about the Padua Score is essential for accurate risk assessment and appropriate clinical decision making. Addressing these misconceptions improves the quality of VTE prevention and patient outcomes.
Risk Factor Assessment Misconceptions
A common misconception is that all elderly patients automatically require thromboprophylaxis. While age ≥70 years is a risk factor, it must be considered in the context of other factors. The Padua Score requires age ≥70 years specifically, not just advanced age. Another misconception is that obesity alone justifies thromboprophylaxis. While obesity (BMI ≥30) is a risk factor, it should be assessed in combination with other factors. BMI should be calculated using actual measurements rather than estimates.
Scoring System Misunderstandings
Some clinicians incorrectly believe that the Padua Score is cumulative without limits. However, the scoring system has a maximum theoretical score of 20 points, though scores above 12 are rare in clinical practice. Another misconception is that the score can be applied to all hospitalized patients. The Padua Score is specifically validated for medical patients and should not be used for surgical patients, who have different risk assessment tools. The score is also not validated for pediatric patients or pregnant women.
Clinical Integration Errors
A common error is applying the Padua Score without considering contraindications to thromboprophylaxis. Patients with active bleeding, severe thrombocytopenia, or other bleeding risks may not be candidates for pharmacological prophylaxis despite high scores. Another misconception is that the score remains static throughout hospitalization. The Padua Score should be reassessed regularly as patient condition changes, particularly when new risk factors develop or existing ones resolve.

Common Scoring Errors to Avoid:

  • Including age <70 years as a risk factor
  • Using estimated BMI instead of measured values
  • Applying the score to surgical or pediatric patients
  • Failing to reassess the score during hospitalization

Mathematical Derivation and Examples

  • Scoring Algorithm
  • Risk Probability Calculation
  • Clinical Validation Studies
The Padua Score is based on a mathematical model derived from multivariate analysis of clinical risk factors for VTE in medical patients. Understanding the mathematical foundation helps clinicians interpret results and make informed decisions about thromboprophylaxis.
Scoring Algorithm and Weighting
The Padua Score uses a weighted scoring system where each risk factor is assigned points based on its independent contribution to VTE risk. Major risk factors (previous VTE, active cancer, reduced mobility) receive 3 points each due to their strong association with VTE. Moderate risk factors (age ≥70, obesity, recent trauma/surgery) receive 1-2 points each. Minor risk factors (heart failure, respiratory failure, acute MI/stroke, infection, hormonal treatment, thrombophilia) receive 1 point each. The total score represents the cumulative risk burden.
Risk Probability Calculation
The VTE probability is calculated using logistic regression models derived from validation studies. For scores <4, the VTE probability is approximately 0.3-1.0% during hospitalization. For scores ≥4, the VTE probability increases to approximately 4-11%. The exact probability varies based on the specific combination of risk factors and the patient population. The risk is highest during the first 2 weeks of hospitalization and decreases with time.
Clinical Validation and Performance Metrics
The Padua Score has been validated in multiple studies with excellent performance metrics. The original validation study showed sensitivity of 87% and specificity of 67% for identifying high-risk patients. The positive predictive value is approximately 11% and negative predictive value is 99%. The score demonstrates good calibration across different populations and healthcare settings. Recent studies have confirmed the score's performance in contemporary patient populations and different healthcare systems.

Mathematical Examples:

  • Score 2: 0.5% VTE probability, low risk, no prophylaxis needed
  • Score 5: 6.5% VTE probability, high risk, prophylaxis recommended
  • Score 8: 9.2% VTE probability, very high risk, aggressive prophylaxis
  • Score 12: 11.0% VTE probability, extremely high risk, intensive monitoring