PADUA score as a predictor for pulmonary embolism: a potential strategy for reducing unnecessary imaging

Kandagatla, Pridvi; Goranta, Sowmya; Antoine, Heath J.; Marashi, Seyed Mani; Schmoekel, Nathan; Gupta, Arielle Hodari

doi:10.1007/s11239-018-01801-w

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…From this, it can be seen that the high specificity and negative predictive value of the Padua risk assessment model can prevent patients from undergoing unnecessary imaging examinations. 26 This is consistent with our research findings that the Padua risk assessment model has high specificity. During the COVID-19 pandemic, Chinese scholars used the Padua risk assessment model to stratify the risk of 143 COVID-19 patients.…”

Section: Discussionsupporting

confidence: 93%

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

Chen,

Shi,

Chang

et al. 2024

Clin Appl Thromb Hemost

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To external validate the risk assessment model (RAM) of venous thromboembolism (VTE) in multicenter internal medicine inpatients. We prospectively collected 595 internal medical patients (310 with VTE patients, 285 non-VTE patients) were from Beijing Shijitan Hospital, Beijing Chaoyang Hospital, and the respiratory department of Beijing Tsinghua Changgeng Hospital from January 2022 to December 2022 for multicenter external validation. The prediction ability of Caprini RAM, Padua RAM, The International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) RAM, and Shijitan (SJT) RAM were compared. This study included a total of 595 internal medicine inpatients, including 242 (40.67%) in the respiratory department, 17 (2.86%) in the respiratory intensive care unit, 49 (8.24%) in the neurology department, 34 (5.71%) in the intensive care unit, 26 (4.37%) in the geriatric department, 22 (3.70%) in the emergency department, 71 (11.93%) in the nephrology department, 63 (10.59%) in the cardiology department, 24 (4.03%) in the hematology department, 6 (1.01%) in the traditional Chinese medicine department, 9 (1.51%) cases in the rheumatology department, 7 (1.18%) in the endocrinology department, 14 (2.35%) in the oncology department, and 11 (1.85%) in the gastroenterology department. Multivariate logistic regression analysis showed that among internal medicine inpatients, age > 60 years old, heart failure, nephrotic syndrome, tumors, history of VTE, and elevated D-dimer were significantly correlated with the occurrence of VTE ( P < .05). The incidence of VTE increases with the increase of D-dimer. It was found that the effectiveness of SJT RAM (AUC = 0.80 ± 0.03) was better than Caprini RAM (AUC = 0.74 ± 0.03), Padua RAM (AUC = 0.72 ± 0.03) and IMPROVE RAM (AUC = 0.52 ± 0.03) ( P < .05). The sensitivity and Yoden index of SJT RAM were higher than those of Caprini RAM, Pauda RAM, and IMPROVE RAM ( P < .05), but specificity was not significantly different between the 4 models ( P > .05). The SJT RAM derived from general hospitalized Chinese patients has effective and better predictive ability for internal medicine inpatients at risk of VTE.

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Section: Discussionsupporting

confidence: 93%

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

Chen,

Shi,

Chang

et al. 2024

Clin Appl Thromb Hemost

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“…Other studies have also identified hormonal treatment as a risk factor for PE [ 34 ]. Moreover, existing research has confirmed the association between immobility and VTE [ 13 , 31 ]. The present study revealed that a significant proportion of patients (87.0%) underwent surgery, which was associated with prolonged surgical duration, and a considerable percentage of patients (49.3%) had active cancer, both of which are known to potentially impede mobility and result in an extended period of bed rest.…”

Section: Discussionmentioning

confidence: 92%

Validation of a pulmonary embolism risk assessment model in gynecological inpatients

Jin,

Li,

et al. 2024

Thrombosis J

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Objective To compare the predictive efficacy of the PADUA and Caprini models for pulmonary embolism (PE) in gynecological inpatients, analyze the risk factors for PE, and validate whether both models can effectively predict mortality rates. Methods A total of 355 gynecological inpatients who underwent computed tomography pulmonary angiography (CTPA) were included in the retrospective analysis. The comparative assessment of the predictive capabilities for PE between the PADUA and Caprini was carried out using receiver operating characteristic (ROC) curves. Logistic regression analysis was used to identify risk factors associated with PE. Additionally, Kaplan–Meier survival analysis plots were generated to validate the predictive efficacy for mortality rates. Results Among 355 patients, the PADUA and Caprini demonstrated the area under the curve (AUC) values of 0.757 and 0.756, respectively. There was no statistically significant difference in the AUC between the two models (P = 0.9542). Multivariate logistic analysis revealed immobility (P < 0.001), history of venous thromboembolism (VTE) (P = 0.002), thrombophilia (P < 0.001), hormonal treatment (P = 0.022), and obesity (P = 0.019) as independent risk factors for PE. Kaplan–Meier survival analysis demonstrated the reliable predictive efficacy of both the Caprini (P = 0.00051) and PADUA (P = 0.00031) for mortality. ROC for the three- and six-month follow-ups suggested that the Caprini model exhibited superior predictive efficacy for mortality. Conclusions The PADUA model can serve as a simple and effective tool for stratifying high-risk gynecological inpatients before undergoing CTPA. The Caprini model demonstrated superior predictive efficacy for mortality rates.

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“…Many assessment models have been used to evaluate the risk of thrombotic disease in patients, such as the Roger score [ 14 ], Padua score [ 15 ], and Caprini scale [ 16 ], which quantitatively layer the risk in order to guide preoperative thromboprophylaxis. But the efficacy and accuracy of these models are still controversial [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study

et al. 2021

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Background Postoperative pulmonary embolism (PE) is a serious thrombotic complication in the patients with otolaryngologic cancers. We investigated the risk factors associated with postoperative PE after radical resection of head and neck cancers. Methods A total of 3512 patients underwent head and neck cancers radical resection from 2013 to 2019. A one-to-three control group without postoperative PE was selected matched by age, gender, and type of cancer. Univariate analyses were performed for the perioperative patient data including hemodynamic management factors. Conditional logistic regression was used to analyze the factors and their odds ratios. Results Postoperative PE was prevalent in 0.85% (95%CI = 0.56–1.14). Univariate analyses showed that a high ASA grade, high BMI, and smoking history may be related to postoperative PE. There was significantly difference in operation time between the two groups, especially for> 4 h [22(78.6%) vs 43(51.2%), P = .011]. The urine output was lower [1.37(0.73–2.21) ml·kg− 1·h− 1 vs 2.14(1.32–3.46) ml·kg− 1·h− 1, P = .006] and the incidence of oliguria was significantly increased (14.3% vs 1.2%, P = .004) in the PE group. Multivariable conditional logistic regression showed postoperative PE were associated with the cumulative duration for intraoperative hypotension (OR = 2.330, 95%CI = 1.428–3.801, P = .001), oliguria (OR = 14.844, 95%CI = 1.089–202.249, P = .043), and operation time > 4 h (OR = 4.801, 95%CI = 1.054–21.866, P = .043). Conclusions The intraoperative hypotension, oliguria, and operation time > 4 h are risk factors associated with postoperative PE after radical resection of head and neck cancers. Improving intraoperative hemodynamics management to ensure adequate blood pressure and urine output may reduce the occurrence of such complications.

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PADUA score as a predictor for pulmonary embolism: a potential strategy for reducing unnecessary imaging

Cited by 7 publications

References 30 publications

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

Validation of a pulmonary embolism risk assessment model in gynecological inpatients

Intraoperative hypotension, oliguria and operation time are associated with pulmonary embolism after radical resection of head and neck cancers: a case control study

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