Related | Appendix A. VTE Risk Assessment Medical (Padua)
Copyright © 2019 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission. Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 09/2019CCKM@uwhealth.org Venous Thromboembolism Prophylaxis- Adult- Inpatient/Ambulatory Clinical Practice Guideline Appendix A. VTE prophylaxis in medical patients Table 1: Modified Padua Risk Assessment Model Risk Factor Points Critically Ill 4 Inflammatory Bowel Disease 4 Admission for Trauma (injured patient with fracture) 4 Active Cancer 3 Previous VTE 3 Reduced Mobility 3 Thrombophilic Condition 3 Recent (< 1month) Trauma/Surgery 2 Age ≥ 70 years 1 Heart or Respiratory Failure 1 Acute Myocardial Infarction or Ischemic Stroke 1 Acute Infection or Rheumatologic Disorder 1 BMI ≥ 30 1 Ongoing Hormonal Treatment 1 Total Points Low VTE Risk – no prophylaxis needed < 4 High VTE Risk – prophylaxis recommended > 4 Table 2: VTE Prophylaxis Regimens for High VTE Risk Medical Patients Patient Population VTE Prophylaxis Regimens Preferred Option Alternative Option High VTE Risk Enoxaparin 40 mg SQ every 24 hrsa Heparin 5000 units SQ every 8-12 hrsa Trauma/Injury with fracture Enoxaparin 30 mg SQ every 12 hoursa Heparin 5000 unit SQ every 8-12 hoursc Renal impairment (CrCl < 30 mL/min)* *Not on renal replacement therapy Heparin 5000 units SQ every 8-12 hrsa Enoxaparin 30 mg SQ every 24 hrsb Extreme obesity (BMI > 40 kg/M2) Enoxaparin 40 mg SQ every 12 hrsb Heparin 5000 units SQ every 8 hrsb Low body weight (weight < 50 kg) Heparin 5000 units SQ every 8-12 hrsa Enoxaparin 30 mg SQ every 24 hrsc High Bleeding Risk Intermittent pneumatic compression devices (IPC)a Graduated compression stockings (GCS) or Venous foot pumps (VFP)c a: UW Health GRADE Moderate quality evidence, strong recommendation b: UW Health GRADE Low quality evidence, strong recommendation c: UW Health GRADE Low quality evidence, weak/conditional recommendation CPG Contact for Changes: Name: Philip J Trapskin, PharmD, BCPS Phone Number: 263-1328 Email Address: email@example.com Revised: 7/2019 Effective 8/1/2019. Contact CCKM@uwhealth.org for previous versions.