Summary

What it measures:

A screening tool that measures the risk of venous thrombus embolism (VTE).

Target Population:

Validated for use with:

• Nonsurgical hospitalized patients¹
• Recently hospitalized patients (up until 90 days post admission)¹
• Non-ambulatory patients²

TASKFORCE RECOMMENDATIONS

Role of Physical Therapists in the Management of Individuals at risk for or Diagnosed with Venous Thromboembolism Evidence-Based Clinical Practice Guideline 2022 strongly recommends that physical therapists assess risk of venous thrombus embolism (VTE) in patients with reduced mobility. The Padua Prediction Score (PPS) is included in this guideline as a risk assessment model that is particularly useful for hospitalized patients.

American Heart Association's Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients recommends assessing and reporting VTE risk in all hospitalized patients and lists PPS as a tool to help identify nonsurgical hospitalized patients who may benefit from VTE prophylaxis.³

CLINICAL INSIGHTS

Assessing risk of VTE as part of physical therapist examination "will improve patient care by identifying those patients who would benefit from additional information on risk mitigation, such as hydration and the benefit of mobility". ²

The Padua Prediction Score is a simple risk assessment measure (RAM) that inpatient therapists, and outpatient and home health therapists who work with recently hospitalized and/or non-ambulatory patients, can use to increase awareness of patients who are at increased risk of developing VTE. This tool should be used as a guide in conjunction with the physical therapist's clinical judgement.

A PPS score of >4 indicates high risk of VTE. The physical therapist should provide patient education as above and alert the attending provider for potential additional prophylactic management.

There are other RAMs with greater sensitivity, specificity, and predictive power (such as Caprini, Khorana), but those screens include a longer list of predisposing factors, making them more cumbersome to use. Clinicians can consider using one of these tools in patients who have risk factors that PPS does not address.

Additionally, if the health care organization the physical therapist works at uses another risk assessment measure, the PT should use the one chosen by their organization for consistency in communicating the risk of VTE across the spectrum of caregivers.²