Barbar et al reported the Padua Prediction Score (PPS) for identifying a hospitalized patient at risk for venous thromboembolism. This is an extension on a score developed by Kucher et al. The authors are from the University of Padua.
Patient selection: hospitalized medical patient
Parameters:
(1) age in years
(2) active cancer (local or distant metastases and/or chemoradiation in past 6 months)
(3) history of venous thromboembolism (excluding superficial vein thrombosis)
(4) mobility (prolonged bedrest)
(5) history of thrombophilic condition (Factor V Leiden, deficiency of Protein S or Protein C, antiphopsholipid antibody syndrome, prothrombin gene mutation, etc)
(6) time interval since trauma or surgery
(7) heart and/or respiratory failure
(8) acute myocardial infarction and/or ischemic stroke
(9) acute infection and/or rheumatologic disorder
(10) body mass index
(11) ongoing hormonal therapy
|
Parameter |
Finding |
Points |
|
age in years |
< 70 years of age |
0 |
|
|
>= 70 years of age (elderly) |
1 |
|
active cancer |
no |
0 |
|
|
yes |
3 |
|
history of venous thromboembolism |
no |
0 |
|
|
yes |
3 |
|
mobility |
normal or slightly reduced |
0 |
|
|
impaired (bedrest for >= 3 days) |
3 |
|
history of thrombophilia |
no |
0 |
|
|
yes |
3 |
|
time since trauma or surgery |
> 30 days |
0 |
|
|
<= 30 days (1 month) |
2 |
|
heart and/or respiratory failure |
no |
0 |
|
|
yes |
1 |
|
AMI or ischemic stroke |
no |
0 |
|
|
yes |
1 |
|
acute infection or rheumatologic disorder |
no |
0 |
|
|
yes |
1 |
|
body mass index |
< 30 kg per square meter |
0 |
|
|
>= 30 kg per square meter |
1 |
|
ongoing hormonal therapy |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the greater the risk of venous thromboembolism.
• A score >= 4 identifies a patient at increased risk for VTE who may benefit from thromboprophylaxis.
Purpose: To identify an acutely-ill medical patient who should receive thromboprophylaxis based on the study of Chopard et al.
Specialty: Hematology Oncology, Clinical Laboratory
Objective: risk factors
ICD-10: I80, I81, I82,
