{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:07:53Z","timestamp":1790989673277,"version":"4.1.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Venous thromboembolism (VTE) is considered a preventable cause of mortality. The evidence for the benefit of VTE prophylaxis in acute medical patients is non-conclusive. Meta-analysis of RCTs failed to demonstrate reduction of all-cause mortality, while showing higher risk of bleeding. The Israeli Ministry of Health has instructed to assess all acute medical patients for the risk for VTE using the Padua Prediction Score, without mandating prophylaxis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To evaluate the effect of filling the Padua score on clinical outcomes and VTE prophylaxis rates.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective Study was performed in Israel during the years 2014\u20132017. The participants were divided to Padua compliance vs non-compliance group. Primary outcome: 30-day mortality. Secondary outcomes: 90-day incidence of VTE and suspected major bleeding. A propensity-weighted logistic multiple regression was performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>18,890 patients were included in the study. The fulfillment of the Padua score was associated with an increased use of VTE prophylaxis, OR 1.66 (95% CI 1.49\u20131.84). However, there was no reduction of mortality or VTE events, OR 1.13 (95% CI 0.97\u20131.31) and OR 1.22 (95% CI 0.79\u20131.8) respectively. Hospitalizations related to hemoglobin decrease were not statistically different between the two groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Padua score for the assessment of VTE risk in medical wards was associated with higher administration of pharmacological prophylaxis without reduction in VTE or mortality rate. Its usage should be reassessed as a performance measure.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0292661","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T18:36:57Z","timestamp":1707331017000},"page":"e0292661","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["The effect of obligatory Padua prediction scoring in hospitalized medically ill patients: A retrospective cohort study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-3906","authenticated-orcid":true,"given":"Genady","family":"Drozdinsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Zusman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiri","family":"Kushnir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Leibovici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Gafter-Gvili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"pone.0292661.ref001","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11239-015-1311-6","article-title":"The epidemiology of venous thromboembolism.","volume":"41","author":"JA Heit","year":"2016","journal-title":"J Thromb Thrombolysis"},{"key":"pone.0292661.ref002","doi-asserted-by":"crossref","first-page":"S495","DOI":"10.1016\/j.amepre.2009.12.017","article-title":"Venous Thromboembolism.","volume":"38","author":"MG Beckman","year":"2010","journal-title":"American Journal of Preventive Medicine"},{"key":"pone.0292661.ref003","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/014107688908200407","article-title":"Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis?","volume":"82","author":"DA Sandler","year":"1989","journal-title":"J R Soc Med"},{"key":"pone.0292661.ref004","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1056\/NEJM199909093411103","article-title":"A Comparison of Enoxaparin with Placebo for the Prevention of Venous Thromboembolism in Acutely Ill Medical Patients","volume":"341","author":"MM Samama","year":"1999","journal-title":"N Engl J Med"},{"key":"pone.0292661.ref005","doi-asserted-by":"crossref","first-page":"e278S","DOI":"10.1378\/chest.11-2404","article-title":"Prevention of VTE in Orthopedic Surgery Patients.","volume":"141","author":"Y Falck-Ytter","year":"2012","journal-title":"Chest"},{"key":"pone.0292661.ref006","doi-asserted-by":"crossref","first-page":"602","DOI":"10.7326\/0003-4819-155-9-201111010-00008","article-title":"Venous thromboembolism prophylaxis in hospitalized medical patients and those with stroke: a background review for an American College of Physicians Clinical Practice Guideline","volume":"155","author":"FA Lederle","year":"2011","journal-title":"Ann Intern Med"},{"key":"pone.0292661.ref007","first-page":"2014","article-title":"Heparin for the prevention of venous thromboembolism in acutely ill medical patients (excluding stroke and myocardial infarction)","author":"R Alikhan","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"key":"pone.0292661.ref008","article-title":"Venous Thromboembolism Prophylaxis in Acute Medically Ill Patients: A Retrospective Cohort Study","author":"A Gafter-Gvili","year":"2020","journal-title":"The American Journal of Medicine"},{"key":"pone.0292661.ref009","first-page":"15","article-title":"Low venous thromboembolism incidence in high risk medical patients in an Israeli hospital. Can risk assessment be extrapolated to different populations?","author":"O Koren","year":"2020","journal-title":"PLoS One"},{"key":"pone.0292661.ref010","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1111\/j.1538-7836.2010.04044.x","article-title":"A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score","volume":"8","author":"S Barbar","year":"2010","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"pone.0292661.ref011","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1160\/TH14-03-0239","article-title":"External validation of a risk assessment model for venous thromboembolism in the hospitalised acutely-ill medical patient (VTE-VALOURR).","volume":"112","author":"CE Mahan","year":"2014","journal-title":"Thromb Haemost"},{"key":"pone.0292661.ref012","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1160\/TH13-05-0427","article-title":"Multicentre validation of the Geneva Risk Score for hospitalised medical patients at risk of venous thromboembolism. Explicit ASsessment of Thromboembolic RIsk and Prophylaxis for Medical PATients in SwitzErland (ESTIMATE).","volume":"111","author":"M Nendaz","year":"2014","journal-title":"Thromb Haemost"},{"key":"pone.0292661.ref013","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1111\/jth.14796","article-title":"Validation of risk assessment models predicting venous thromboembolism in acutely ill medical inpatients: A cohort study","volume":"18","author":"T Moumneh","year":"2020","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"pone.0292661.ref014","doi-asserted-by":"crossref","first-page":"e195S","DOI":"10.1378\/chest.11-2296","article-title":"Prevention of VTE in Nonsurgical Patients","volume":"141","author":"SR Kahn","year":"2012","journal-title":"Chest"},{"key":"pone.0292661.ref015","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1258\/jrsm.2010.100086","article-title":"NICE guidance on reducing the risk of venous thromboembolism in patients admitted to hospital.","volume":"103","author":"T Treasure","year":"2010","journal-title":"J R Soc Med"},{"key":"pone.0292661.ref016","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2005.01204.x","article-title":"Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients","volume":"3","author":"S Schulman","year":"2005","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"pone.0292661.ref017","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1093\/biomet\/asn055","article-title":"Dealing with limited overlap in estimation of average treatment effects","volume":"96","author":"RK Crump","year":"2009","journal-title":"Biometrika"},{"key":"pone.0292661.ref018","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1111\/jth.12258","article-title":"Physicians\u2019 compliance with the Padua Prediction Score for preventing venous thromboembolism among hospitalized medical patients","volume":"11","author":"V Rossetto","year":"2013","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"pone.0292661.ref019","article-title":"Venous thromboembolism (VTE) risk stratification in general medical patients at an academic medical center.","author":"MK Fritz","year":"2020","journal-title":"J Thromb Thrombolysis"},{"key":"pone.0292661.ref020","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1056\/NEJMp1802595","article-title":"Time Out\u2014Charting a Path for Improving Performance Measurement","volume":"378","author":"CH MacLean","year":"2018","journal-title":"N Engl J Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0292661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T18:37:07Z","timestamp":1707331027000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0292661"}},"subtitle":[],"editor":[{"given":"Maher Abdelraheim","family":"Titi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,7]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0292661","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,7]]}}}