Determines anticoagulation need in hospitalized patients by risk of VTE.
- Many of the patients who developed VTE had active cancer or were older.
- However, this paper does demonstrate an overall lack of appropriate thromboprophylaxis in patients where the benefit may outweigh the risk.
- In the appropriate setting when a physician is already considering thromboprophylaxis for a patient considered high risk for VTE, a Padua score of ≥4 has the potential to support their clinical gestalt.
For patients admitted to a medical floor:
- Padua Score <4: Low risk of VTE.
- Thromboprophylaxis should be considered on a case-by-case basis.
- Padua Score ≥4: High risk of VTE.
- Thromboprophylaxis (i.e. heparin / enoxaparin) is recommended for non-pregnant patients without contraindications (major bleeding, low platelets, creatinine clearance < 30 mL/min) who are >18 years.
- The Padua score is meant to risk stratify patients who have a potential risk for VTE, not to diagnose VTE.
- If deemed appropriate, anticoagulation should not be withheld from patients who require it as part of the treatment for their diagnosis.
- Prior to initiating any anticoagulant therapy a patient’s bleeding risk should be evaluated.