IMPROVE and IMPROVEDD scores for venous thromboembolism
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
To see a risk calculator according to IMPROVEDD scores, click here.
Overview
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.[1]
IMPROVE-DD score for VTE risk stratification
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 whcih 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 IMPROVEDD Associative Score
| Variable | Score[2] |
| 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
| Score | Predicted VTE risk through 42 days[2] |
| 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[2] |
| 0 | 0.5% |
| 1 | 0.7% |
| 2 | 1.0% |
| 3 | 1.4% |
| 4 | 1.9% |
| 5-10 | 2.7% |
IMPROVE Associative Score for VTE
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.[1]
Calculation of the IMPROVE Associative Score
| Variable | Score[1] |
| 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
| Score | Predicted VTE risk through 3 months[1] |
| 0 | 0.4% |
| 1 | 0.6% |
| 2 | 1.0% |
| 3 | 1.7% |
| 4 | 2.9% |
| 5-10 | 7.2% |
References
- ↑ 1.0 1.1 1.2 1.3 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.
- ↑ 2.0 2.1 2.2 2.3 "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.