Healthcare & Clinical Calculations
Bova Score for Normotensive Acute Pulmonary Embolism (Stage I–III)
Stratify 30-day PE-related hemodynamic collapse risk across normotensive pulmonary embolism patients (SBP >= 90 mmHg) using Carlo Bova’s 0–7 score (Borderline SBP 90–100, Elevated Troponin, RV Dysfunction, Heart Rate >= 110).
Spot normotensive "submassive" PE patients on the verge of right-ventricular crash!
Normotensive acute pulmonary embolism patients (Systolic BP >= 90 mmHg) span a huge danger spectrum: most recover smoothly on standard anticoagulation, yet Intermediate-High Risk ("submassive") patients suffer sudden right-ventricular obstructive shock within 48–72 hours! Carlo Bova et al. (European Respiratory Journal 2014) validated a weighted 0–7 prognostic score exclusively for normotensive PE: Systolic BP 90–100 mmHg (+2 points), Elevated Cardiac Troponin (+2 points), Right-Ventricular Dysfunction on echocardiography or CTPA RV/LV >= 0.9–1.0 (+2 points), and Heart Rate >= 110 bpm (+1 point)!
Bova stages predict 30-day PE-related complications (hemodynamic collapse, rescue thrombolysis, or PE death): Stage I (0–2 points) = 3.1–4.2%, Stage II (3–4 points) = 10.8%, and Stage III (5–7 points) surges to 29.2%—flagging immediate Pulmonary Embolism Response Team (PERT) activation, ICU/step-down telemetry, and catheter-directed/rescue reperfusion readiness!
| Bova Score Stage (0–7 Points, SBP >= 90) | 30-Day PE Complication Rate | ESC Submassive Risk Tier | Inpatient Monitoring & PERT Action |
|---|---|---|---|
| Stage I (0–2 Points) | 3.1–4.2% | Low / Intermediate-Low Risk | Standard Ward Anticoagulation |
| Stage II (3–4 Points) | 10.8% | Intermediate Risk | Telemetry & Serial Hemodynamic Checks |
| Stage III (5–7 Points, e.g., 7) | 29.2% Collapse/Mortality | Intermediate-High ("Submassive") | ICU / PERT Consult & Reperfusion Readiness |
Total 4-Variable Bova Normotensive PE Score (0–7 Points)
Guards overt shock SBP < 90 mmHg (already High-Risk/Massive PE) before summing SBP 90–100 (+2), Troponin (+2), RV Dysfunction (+2), and HR >= 110 (+1).
=IF(B2 < 90, "Massive High-Risk PE (SBP < 90) — Bova Applies Only to SBP >= 90", IF(OR(B3 < 0, B3 > 1, B4 < 0, B4 > 1, B5 <= 0), "Invalid Bova Input", IF(B2 <= 100, 2, 0) + 2 * B3 + 2 * B4 + IF(B5 >= 110, 1, 0)))Bova Stage I–III Stratification & PERT Escalation
Classifies normotensive PE into Stage I (0–2), Stage II (3–4), or Stage III (5–7).
=IF(B2 < 90, "Massive High-Risk PE (SBP < 90) — Bova Applies Only to SBP >= 90", IF(OR(B3 < 0, B3 > 1, B4 < 0, B4 > 1, B5 <= 0), "Invalid Bova Input", IF((IF(B2 <= 100, 2, 0) + 2 * B3 + 2 * B4 + IF(B5 >= 110, 1, 0)) >= 5, "Bova Stage III (5-7 Pts: ~29.2% Complication Risk) — PERT Activation & ICU Monitoring", IF((IF(B2 <= 100, 2, 0) + 2 * B3 + 2 * B4 + IF(B5 >= 110, 1, 0)) >= 3, "Bova Stage II (3-4 Pts: ~10.8% Complication Risk) — Telemetry Monitoring", "Bova Stage I (0-2 Pts: ~3.1-4.2% Risk) — Standard Anticoagulation"))))Try the example
Use the original values or change them to test your understanding.