Padua Prediction Score (VTE Risk)
Risk stratification tool for VTE in hospitalised medical patients
For use by health professionals only. This tool does not replace clinical judgement, local guidelines, or a separate bleeding-risk assessment. Not for patient self-management.
Risk factors
Padua Prediction Score: 0
Risk category: Not yet calculated
Select the relevant risk factors and click “Calculate score” to see the Padua score and its interpretation.
Interpretation (for medical inpatients): score 0–3 = low VTE risk; score ≥4 = high VTE risk where pharmacological VTE prophylaxis is usually recommended unless contraindicated, in line with local guidelines.
The Padua Prediction Score is a clinical risk assessment model used in hospitalised medical patients (not surgical patients) to estimate the risk of venous thromboembolism (VTE) and guide the decision to start VTE prophylaxis (usually anticoagulants). It was developed by Barbar et al. in 2010 by identifying independent risk factors for hospital-acquired VTE and assigning each a weighted point value.ScienceDirect
How the Padua Prediction Score works
The score is calculated by summing points for the following risk factors:Queensland Health+1
- Active cancer (including recent chemo/radiotherapy or metastases) – 3 points
- Previous VTE (excluding superficial thrombophlebitis) – 3 points
- Reduced mobility (bed rest ≥3 days with bathroom privileges) – 3 points
- Known thrombophilia (e.g. antithrombin, protein C/S deficiency, factor V Leiden, prothrombin G20210A, antiphospholipid syndrome) – 3 points
- Recent trauma and/or surgery ≤1 month – 2 points
- Age ≥70 years – 1 point
- Heart and/or respiratory failure – 1 point
- Acute myocardial infarction or ischaemic stroke – 1 point
- Acute infection and/or rheumatologic disorder – 1 point
- Obesity (BMI ≥30 kg/m²) – 1 point
- Ongoing hormonal treatment (e.g. oestrogen therapy) – 1 point
Total score ranges from 0 to 20.
Interpreting the Padua score
Most guidelines and validation studies use a threshold of 4 points:Queensland Health+2acforum-excellence.org+2
- 0–3 points: Low risk of VTE
- Routine pharmacological VTE prophylaxis is generally not indicated, but decisions may still be individualised and mechanical prophylaxis or other measures may be considered depending on local policy and bleeding risk.
- ≥4 points: High risk of VTE
- Associated with a substantially higher rate of hospital-acquired VTE (around 11% at 90 days without prophylaxis vs ~0.3% in low-risk patients).PLOS
- Pharmacological VTE prophylaxis is usually recommended unless contraindicated (e.g. active bleeding, very high bleeding risk, severe thrombocytopenia), following local protocols.
Limitations and good practice
- The Padua score is not a bleeding-risk tool; bleeding risk must be assessed separately.
- It was derived in medical inpatients, so use in other populations needs caution.PMC+1
- Risk can change during admission; re-assessment after a few days may be appropriate in some settings.ScienceDirect
