IMPROVE bleeding risk score: Difference between revisions

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==Overview==
==Overview==
The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.
==IMPROVE Bleeding Risk Score==
The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>
The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>


==IMPROVE Bleeding Risk Score==
==IMPROVE Bleeding Risk Score Calculator==
===Calculation of the IMPROVE Bleeding Risk Score===


{| style="cellpadding=0; cellspacing= 0; width: 600px;"
{| style="cellpadding=0; cellspacing= 0; width: 600px;"
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| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center | '''Variable'''||style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align=center | '''Score'''<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>
| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Variable'''|| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Score'''<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>
|-
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Active [[gastric ulcer|gastric]] or [[duodenal ulcer]] || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |4.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Active [[gastric ulcer|gastric]] or [[duodenal ulcer]] || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Prior [[bleeding]] within the last 3 months|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |4
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Prior [[bleeding]] within the last 3 months|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |[[Thrombocytopenia]] (<50x10<sup>9</sup>/L)||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |4
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Thrombocytopenia]] (<50x10<sup>9</sup>/L)|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Age ≥ 85 years||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |3.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Age ≥ 85 years|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |[[Liver failure]] ([[INR]]>1.5)||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Liver failure]] ([[INR]]>1.5)|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |[[Kidney failure|Severe kidney failure]] ([[GFR]]< 30 mL/min/m<sup>2</sup>)||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Kidney failure|Severe kidney failure]] ([[GFR]]< 30 mL/min/m<sup>2</sup>)|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Admission to [[ICU]] or [[CCU]]||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Admission to [[ICU]] or [[CCU]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |[[Central venous catheter]]||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Central venous catheter]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Rheumatic disease||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Rheumatic disease|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Active [[malignancy]]||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |2
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Active [[malignancy]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2
|-
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Age: 40-84 years|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |1.5
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Age: 40-84 years|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.5
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Male||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |1
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Male|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |[[Kidney failure|Moderate kidney failure]] ([[GFR]]: 30-59 mL/min/m<sup>2</sup>)||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |1
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Kidney failure|Moderate kidney failure]] ([[GFR]]: 30-59 mL/min/m<sup>2</sup>)|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1
|}
|}


==Interpretation==


===Interpretation of the IMPROVE Bleeding Risk Score===
The IMPROVE risk score for bleeding can be interpreted as such:<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>
* Score ≥7: Increased risk of bleeding
* Score <7: Not increased risk of bleeding


The IMPROVE risk score for bleeding can be interpreted as such:<ref name="pmid20453069">{{cite journal| author=Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK et al.| title=Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators. | journal=Chest | year= 2011 | volume= 139 | issue= 1 | pages= 69-79 | pmid=20453069 | doi=10.1378/chest.09-3081 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453069  }} </ref>
==See also==
* '''Score ≥7: Elevated risk of bleeding'''
* [[IMPROVE VTE risk score]]
* '''Score <7: Not elevated risk of bleeding'''


*[[IMPROVEDD VTE risk score]]
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 06:01, 10 February 2019

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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]

Overview

The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.

IMPROVE Bleeding Risk Score

The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.[1]

IMPROVE Bleeding Risk Score Calculator

Variable Score[1]
Active gastric or duodenal ulcer 4.5
Prior bleeding within the last 3 months 4
Thrombocytopenia (<50x109/L) 4
Age ≥ 85 years 3.5
Liver failure (INR>1.5) 2.5
Severe kidney failure (GFR< 30 mL/min/m2) 2.5
Admission to ICU or CCU 2.5
Central venous catheter 2
Rheumatic disease 2
Active malignancy 2
Age: 40-84 years 1.5
Male 1
Moderate kidney failure (GFR: 30-59 mL/min/m2) 1

Interpretation

The IMPROVE risk score for bleeding can be interpreted as such:[1]

  • Score ≥7: Increased risk of bleeding
  • Score <7: Not increased risk of bleeding

See also

References

  1. 1.0 1.1 1.2 Decousus H, Tapson VF, Bergmann JF, Chong BH, Froehlich JB, Kakkar AK; et al. (2011). "Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators". Chest. 139 (1): 69–79. doi:10.1378/chest.09-3081. PMID 20453069.

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