Bova Score for Pulmonary Embolism Complications
Use ONLY in hemodynamically stable patients (sBP ≥90) with confirmed acute PE (pulmonary embolism).
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- Risk of PE-related complications (death from PE, hemodynamic collapse, or recurrent nonfatal PE) increases in patients with higher Bova Score.
- Consider assessing high-risk patients for advanced therapy in addition to anticoagulation (catheter-directed therapy, thrombolytic therapy, IVC filter placement) if warranted.
- Consider monitoring patients with intermediate and high risk Bova Scores in a higher level of care (stepdown unit, ICU).
- Consider standard treatment (anticoagulation alone) for patients with a low risk Bova Score.
- Optimal management of intermediate risk patients with acute PE is unclear, but escalation of care (e.g. thrombolysis, referral to ICU) should be considered in patients who are not low risk.
- Consider multidisciplinary discussion regarding treatment options for patients with a high risk (>4) Bova Score.
- High risk patients (stage III) should be monitored closely and a plan for rescue therapy should be made in case of clinical deterioration.
- Stage III patients may warrant multidisciplinary discussion regarding management.
- Additional findings and pathology not included in the Bova Score should also be considered, such as respiratory rate, need for respiratory support, SpO₂, syncope, elevated lactic acid, coexisting DVT, and other underlying chronic comorbidities.
- The Bova Score does not predict risks of therapy such as bleeding with thrombolytic therapy or anticoagulation.
- Akhil Khosla, MD
- Robyn Scatena, MD