title: A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score.
abstract: BACKGROUND
  Prophylaxis of venous thromboembolism (VTE) in hospitalized medical patients is largely underused. We sought to assess the value of a simple risk assessment model (RAM) for the identification of patients at risk of VTE.
  
  
  METHODS
  In a prospective cohort study, 1180 consecutive patients admitted to a department of internal medicine in a 2-year period were classified as having a high or low risk of VTE according to a predefined RAM. They were followed-up for up to 90 days to assess the occurrence of symptomatic VTE complications. The primary study outcome was to assess the adjusted hazard ratio (HR) of VTE in high-risk patients who had adequate in-hospital thromboprophylaxis in comparison with those who did not, and that of VTE in the latter group in comparison with low-risk patients.
  
  
  RESULTS
  Four hundred and sixty-nine patients (39.7%) were labelled as having a high risk of thrombosis. VTE developed in four of the 186 (2.2%) who received thromboprophylaxis, and in 31 of the 283 (11.0%) who did not (HR of VTE, 0.13; 95% CI, 0.04-0.40). VTE developed also in two of the 711 (0.3%) low-risk patients (HR of VTE in high-risk patients without prophylaxis as compared with low-risk patients, 32.0; 95% CI, 4.1-251.0). Bleeding occurred in three of the 186 (1.6%) high-risk patients who had thromboprophylaxis.
  
  
  CONCLUSIONS
  Our RAM can help discriminate between medical patients at high and low risk of VTE. The adoption of adequate thromboprophylaxis in high-risk patients during hospitalization leads to longstanding protection against thromboembolic events with a low risk of bleeding.
authors.affiliation: Department of Cardiothoracic and Vascular Sciences, Second Division of Internal Medicine, University of Padua, Padova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Barbar
authors.forename: F
authors.initials: F
authors.lastname: Noventa
authors.forename: V
authors.initials: V
authors.lastname: Rossetto
authors.forename: A
authors.initials: A
authors.lastname: Ferrari
authors.forename: B
authors.initials: B
authors.lastname: Brandolin
authors.forename: M
authors.initials: M
authors.lastname: Perlati
authors.forename: E
authors.initials: E
authors.lastname: De Bon
authors.forename: D
authors.initials: D
authors.lastname: Tormene
authors.forename: A
authors.initials: A
authors.lastname: Pagnan
authors.forename: P
authors.initials: P
authors.lastname: Prandoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000150:complications; D006760:Hospitalization; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*