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IMPROVE and IMPROVEDD scores for venous thromboembolism

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2] Anmol Pitliya, M.B.B.S. M.D.[3]


To see a risk calculator according to IMPROVEDD scores, click here.

To see a risk calculator according to IMPROVE scores, click here.

Overview[edit | edit source]

The IMPROVE score for venous thromboembolism (VTE) assesses the risk of VTE among hospitalized medical patients. The IMPROVE predictive score for VTE includes 4 independent risk factors for VTE which are present at admission. The IMPROVE associative score for VTE includes 7 variables present either at admission or during hospitalization; however, the timing of the presence of some of the factors compared to the onset of VTE was not available. The IMPROVEDD score adds D-dimer as a recognized risk factor to the conventional IMPROVE associative score which includes 7 variables present either at admission or during hospitalization.

IMPROVE-DD score for VTE risk stratification[edit | edit source]

The IMPROVEDD VTE risk score assesses the risk of VTE among hospitalized medical patients. The IMPROVEDD score adds D-dimer as a recognized risk factor to the conventional IMPROVE associative score which includes 7 variables present either at admission or during hospitalization; however the timing of the presence of some of the factors compared to the onset of VTE is not available.[1]

Calculation of the IMPROVEDD Associative Score[edit | edit source]

Variable Score[1]
Prior episode of VTE 3
Thrombophilia 2
Paralysis of the lower extremity during the hospitalization 2
Current malignancy 2
D-dimer ≥ 2x Upper Limit of Normal (ULN) 2
Immobilization for at least 7 days 1
ICU or CCU admission 1
Age more than 60 years 1

Interpretation of the IMPROVEDD Associative Score[edit | edit source]

Score Predicted VTE risk through 42 days[1]
0 0.4%
1 0.6%
2 0.8%
3 1.2%
4 1.6%
5-10 2.2%
Score Predicted VTE risk through 77 days[1]
0 0.5%
1 0.7%
2 1.0%
3 1.4%
4 1.9%
5-10 2.7%

IMPROVE Associative Score for VTE[edit | edit source]

IMPROVE associative risk score assesses the risk of VTE among hospitalized medical patients. While the IMPROVE predictive score includes 4 independent risk factors for VTE which are present at admission, IMPROVE associative score includes 7 variables present either at admission or during hospitalization; however the timing of the presence of some of the factors compared to the onset of VTE is not available.[2]

Calculation of the IMPROVE Associative Score[edit | edit source]

Variable Score[2]
Prior episode of VTE 3
Thrombophilia 2
Paralysis of the lower extremity during the hospitalization 2
Current malignancy 2
Immobilization for at least 7 days 1
ICU or CCU admission 1
Age more than 60 years 1

Interpretation of the IMPROVE Associative Score[edit | edit source]

Score Predicted VTE risk through 3 months[2]
0 0.4%
1 0.6%
2 1.0%
3 1.7%
4 2.9%
5-10 7.2%

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 "The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification". doi:10.1055/s-0037-160392910.1055/s-0037-1603929.
  2. 2.0 2.1 2.2 Spyropoulos AC, Anderson FA, Fitzgerald G, Decousus H, Pini M, Chong BH; et al. (2011). "Predictive and associative models to identify hospitalized medical patients at risk for VTE". Chest. 140 (3): 706–14. doi:10.1378/chest.10-1944. PMID 21436241.

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