title: Padua prediction score and thrombin generation in hospitalized medical patients.
abstract: BACKGROUND
  The Padua prediction score is a risk assessment model used to identify medical patients at high risk for venous thromboembolim (VTE).We aimed to assess the relationship between the severity of Padua score and thrombin generation as a measure of overall thrombotic activity.
  
  
  METHODS
  A total of 253 patients hospitalized in the medical wards, at the Haemek Medical Center, Israel, were enrolled in the study. Patients treated with anticoagulation, and those admitted for VTE were excluded. Padua score was classified into two categories; low-risk for VTE (<4 points), and high-risk for VTE (≥4 points). Thrombin generation was assessed by the Calibrated Automated Thrombogram (CAT) method.
  
  
  RESULTS
  Overall 187 (73.9%) patients had Padua score<4, and 66 (26.1%) patients had Padua score ≥4. Comparison of the thrombogram parameters between the two Padua score categories showed no significant difference; lag time (P=0.066), ETP (P=0.266), peak height (P=0.418), and time to peak (P=0.415). Among the individual Padua score risk factors, only active cancer was significantly associated with peak height, myocardial infarction or stroke with lag time, and none of the risk factors was significantly associated with ETP. Because of their low frequency, the association with previous VTE, known thrombophilia, hormonal treatment, and recent trauma or/and surgery was not assessed.
  
  
  CONCLUSIONS
  Single thrombin generation measurement obtained at the same time in acutely hospitalized patients didn't bear any correlation with the Padua prediction score. This finding should be interpreted with caution considering the underrepresentation of risk factors that may influence thrombin generation.
authors.affiliation: Department of Internal Medicine C, Ha'emek Medical Center, Afula, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: saliba_wa@clalit.org.il.
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.affiliation: Department of Internal Medicine A, Ha'emek Medical Center, Afula, Israel.
authors.forename: Wael
authors.initials: W
authors.lastname: Zahalka
authors.affiliation: Department of Internal Medicine C, Ha'emek Medical Center, Afula, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clinical Pharmacology Unit, Ha'emek Medical Center, Afula, Israel.
authors.forename: Lee
authors.initials: L
authors.lastname: Goldstein
authors.affiliation: Department of Internal Medicine C, Ha'emek Medical Center, Afula, Israel.
authors.forename: Gilat
authors.initials: G
authors.lastname: Ron
authors.affiliation: Department of Internal Medicine C, Ha'emek Medical Center, Afula, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Mazen
authors.initials: M
authors.lastname: Elias
mesh_terms: D000368:Aged; D001780:Blood Coagulation Tests; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013917:Thrombin / Q000032:analysis*; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D013917:Thrombin
keywords: Calibrated Automated Thrombogram; Padua score; Thrombin generation