Padua Prediction Score and Hospital Acquired Proximal and Isolated Distal Deep Vein Thrombosis

Abstract Hospital acquired deep vein thrombosis (DVT) is an important cause of morbidity and mortality. The purpose of this study was to evaluate the prevalence of lower limb proximal DVT and isolated distal DVT (IDDVT) and the relationship with the Padua Prediction score (PPS) in acutely ill hospitalized medical patients. In a single center cross-sectional study, all inpatients from medical departments with suspected lower-extremity DVT were evaluated with whole-leg ultrasonography during 183 days from 2016 to 2017. Among the 507 inpatients (age 78.0±13.3 y, females 59.2%) from medical departments, 204 (40.2%) had PPS ≥4, but only 54.4% of them underwent pharmacological thrombo-prophylaxis. Whole leg ultrasonography detected 47 proximal DVTs (9.3%) and 65 IDDVTs (12.8%). Proximal DVT prevalence was higher in patients with high PPS vs those with low PPS (12.7% vs. 7.0% p=0.029, respectively), whereas IDDVT prevalence was similar in patients with high and low PPS score (14.7% vs. 11.6% p=0.311, respectively). The area under the receiver operating curve (AUC) for the PPS was 0.62±0.03 for all DVTs, 0.64±0.04 for proximal DVT, 0.58±0.04 for IDDVT. In hospitalized patients, IDDVT has a similar prevalence regardless of PPS risk stratification. Adherence to thrombo-prophylaxis in medical patients was still far from optimal.