Padua Prediction Score for VTE Risk in Medical Inpatients
Validated 11-item risk stratification tool for VTE in hospitalised medical patients. Score 4 or above = high risk; anticoagulant thromboprophylaxis recommended. Validated by Barbar et al. 2010 in 1,180 patients. Endorsed by ACCP and NICE NG89 for prophylaxis decisions in medical inpatients.
Score interpretation
Padua score below 4 -- low risk of VTE in this admission
→ Pharmacological thromboprophylaxis NOT routinely recommended; prescribe mechanical prophylaxis (TED stockings and IPC if tolerated); ensure adequate hydration; early mobilisation; reassess daily; document VTE risk assessment in notes per NICE NG89.
Padua score 4 or above -- high VTE risk; pharmacological prophylaxis indicated
→ Prescribe LMWH (enoxaparin 40 mg OD SC or dalteparin 5000 units OD SC) or fondaparinux 2.5 mg OD SC if renally adjusted; assess bleeding risk; add mechanical prophylaxis (TED + IPC); continue for duration of hospitalisation; document VTE risk and decision in notes.
Interpretation bands for the Padua VTE Score. Apply clinical judgement and local guidance.
References
- Barbar S 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.
- NICE NG89. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired DVT or PE. 2018 (updated 2023).
Related
Curated clinical cross-links plus same-class fallbacks.
- HERDOO2 Rule for Discontinuing Anticoagulation in Unprovoked VTE · Venous Thromboembolism
- RIETE Score for Bleeding Risk in VTE · Venous Thromboembolism
- Wells Criteria for PE · Venous Thromboembolism
- Wells Criteria for DVT · Venous Thromboembolism
- PERC Rule for PE · Venous Thromboembolism
- Revised Geneva Score for PE · Venous Thromboembolism
- Enoxaparin (VTE in Pregnancy) · Low Molecular Weight Heparin (LMWH) — VTE Prophylaxis/Treatment
- Low Molecular Weight Heparin (Pregnancy VTE) · Anticoagulant — VTE Treatment and Prophylaxis in Pregnancy
- Enoxaparin (Orthopaedic VTE Prophylaxis) · Low Molecular Weight Heparin (LMWH)
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Enoxaparin (Burns — VTE Prophylaxis) · Low Molecular Weight Heparin — VTE Prophylaxis
- Rivaroxaban (PE Treatment) · Venous Thromboembolism
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.