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A Practical Guide to Haemostasis


Assessing the Risk of Bleeding:
The IMPROVE Bleeding Risk Assessment Score

Introduction

The IMPROVE bleeding risk score was designed to estimate the risk of bleeding in acutely ill hospitalised patients in whom anticoagulation is being considered.

The IMPROVE Bleeding Risk Score:


Select Criteria:

Age
≥85 yrs 3.5 Points
40-84 yrs 1.5 Points
<40 yrs 0 Points
Gender
Male 1 Point
Female 0 Points
Renal Function
Normal Renal Function [GFR ≥60 ml/min/m2 0 Points
Moderate Renal Failure [GFR 30-59 ml/min/m2 1 Point
Severe Renal Failure [GFR <30 ml/min/m2 2.5 Points
Liver Function
Normal Liver Function [INR ≤ 1.5] 0 Points
Liver Failure [INR > 1.5] 2.5 Points
Platelet Count
≥50 x 109/L 0 Points
<50 x 109/L 4 Points
Admission to ICU or CCU
  2.5 Points
Central Venous Catheter
  2 Points
Active Gastric or Duodenal Ulcer
  4.5 Points
Prior Bleeding within previous 3 months
  4 Points
Rheumatic Disease
  2 Points
Active Malignancy
  2 Points

Score

[Max Score 30.5 Points]

Interpretation
Score Bleed Risk Category
<7 Not at increased risk of bleeding
≥7 Increased risk of bleeding


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