Always consider use of the mechanical VTE prophylaxis, such as:
• Compression stockings; or
• Intermittent pneumatic compression devices.
Our Padua score calculator checks on the most essential venous thromboembolism (VTE) risk factors of your patient and informs you whether the use of the pharmacological prophylaxis is necessary.
Our tool will not only compute the Padua prediction score, but thanks to the article included below, you'll be able to find out more about the DVT prophylaxis guidelines and VTE risk assessment process.
A word or two about the VTE
VTE stands for the venous thromboembolism. It is a group of diseases of different manifestations and complications that share a common origin: the famous triad of Virchow and the hypercoagulation defect.
|💡 Virchow's triad includes hemodynamic changes (e.g., stasis), endothelial injury/dysfunction, and the changes in the constitution of blood|
VTE usually begins from the episode of the venous thrombosis (a blood clot forming in one of the veins), which may take the form of:
DVT - deep vein thrombosis
The most common type, characterized by a swollen, warm, painful limb.
CVST- cerebral venous sinus thrombosis
Rare type of stroke - often diagnosed in pregnant/postpartum women.
Budd-Chiari syndrome thrombosis of the hepatic vein
May result in liver insufficiency.
The formed and detached clot, then called embolus, may travel further into the cardiovascular system, blocking other veins/arteries. That may result in:
📍 Pulmonary embolism - blockage of one of the lungs arteries.
The symptoms vary from shortness of breath to sudden death.
📍 Paradoxical embolism - blockage of one of the brain arteries, resulting in a stroke.
This situation is only possible in people with defects in heart structure, e.g., in atrial septum.
What are the methods for VTE risk assessment?
Different medical facilities may use their own VTE/DVT risk scores, developed in their own clinical surroundings. However, a group of recommended tools may further facilitate the decision if the pharmacological prophylaxis' gains outweigh the possible side effects.
Your diagnostic process should start with the least invasive methods, such as measuring D-dimers, and checking for the signs and symptoms of the DVT (usually present in lower limbs). You may also perform ultrasound compression testing - probe pressed against an affected vessel will reveal a formed thrombus.
|❗ In case of a life threatening VTE signs/symptoms, heart or lungs insufficiency, you should always speed up the diagnostics (with the use of CT or angio-CT) and implement treatment as soon as possible.|
There are two well-known tools for pulmonary embolism:
They both focus on age, presence of the DVT, reduced mobility, and concomitant diseases.
We may also enumerate two other famous VTE risk score calculators:
- Padua score
- Caprini score
What is the VTE prophylaxis?
Venous thromboembolism prophylaxis comprises of both pharmacological and mechanical methods.
- Compression stockings;
- Intermittent pneumatic compression devices;
- Calf exercise, "pumping"; and
- Early ambulation after surgery.
Pharmacological: (anticoagulation) 💊
- Low molecular weight heparin (LMWH), or unfractionated heparin (UFH);
- Vitamin K antagonists;
- Direct oral anticoagulants (DOACs); and
- Aspirin (only in combination with another drug).
The use of pharmacological prophylaxis doesn't exclude the use of the mechanical one!
How to calculate the Padua score?
Our Padua score calculator uses the following equation:
Padua score = Age + Obesity + Reduced mobility + Hormonal treatment+ Active cancer + Trauma/surgery + Previous VTE + Thrombophilic condition + Failure + Myocardial infraction + Infection
The enumerated variables take the following values:
|Age ≥ 70 years||1||0|
|Obesity (≥30 BMI)||1||0|
|Trauma/surgery (≤ 1 month)||2||0|
|History of VTE||3||0|
|❗ Our calculator shouldn't be used as a substitute for clinical judgment. Always make your decisions based on your own experience and your patient's state. Always consult at least one other source of knowledge.|