The Cardiovascular
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Bova score for pulmonary embolism complications

Risk of 30-day complications in normotensive acute pulmonary embolism.

Bova score for pulmonary embolism complications
Systolic BP 90–100 mmHg
Elevated cardiac troponin
Right ventricular dysfunction (echocardiography or CT)
Heart rate ≥110 bpm
Result0 points

Bova stage I — 30-day PE-related complications ≈4%, PE-related mortality ≈3%.

Bova stage
I
30-day complications
≈4%
30-day PE mortality
≈3%

When to use

  • Further stratifying normotensive (haemodynamically stable) acute PE beyond low-risk classification.

Formula

Points: SBP 90–100 mmHg 2, elevated troponin 2, RV dysfunction 2, heart rate ≥110 bpm 1. Range 0–7. Stage I 0–2, Stage II 3–4, Stage III >4.

Pearls and pitfalls

  • Applies only to patients who are normotensive (SBP >90 mmHg); overt shock is already high-risk PE.
  • The stage-specific rates shown are from the Fernández 2015 validation cohort (complications 4.4/18/42%; PE-related mortality 3.1/6.8/10.5%); the original derivation reported complication rates of 4.2/10.8/29.2%.

References

  1. Bova C, et al. Eur Respir J. 2014;44(3):694-703.
  2. Fernández C, et al. Chest. 2015;148(1):211-8.