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A Practical Guide to Haemostasis


Assessing the Risk of Venous Thromboembolism [VTE] in Hospitalised Medical Patients:
The IMPROVE Predictive, IMPROVE Associative and IMPROVEDD Scores.

Introduction

The IMPROVE Predictive score was designed to assesses the risk of VTE in hospitalised medical patients. The IMPROVE Predictive score for VTE includes 4 independent risk factors for VTE present at admission.
The IMPROVE Associative score includes 7 variables present either at admission or during hospitalization.
The IMPROVEDD score adds D-dimer as a recognized risk factor to the conventional IMPROVE associative score.

The IMPROVEDD Associative Score:


This predicts the VTE risk in medical patients during hospitalisation and includes 7 variables present either at admission or during hospitalisation but in addition the IMPROVEDD score adds D-dimer as an additional risk factor.

Select Criteria:

Previous VTE
Yes
3 Points
Thrombophilia
Yes
2 Points
Paralysis of the lower extremities during hospitalisation
Yes
2 Points
Current Malignancy
Yes
2 Points
Immobilisation for at least 7 days
Yes
1 Point
ICU or CCU admission
Yes
1 Point
Age >60 yrs
Yes
1 Point


Score
[Max score 12]

IMPROVEDD Score
  42-day Predicted VTE Risk
0 0.4%
1 0.6%
2 1.0%
3 1.7%
4 2.9%
5-10 7.2%

IMPROVEDD Score
  77-day Predicted VTE Risk
0 0.5%
1 0.7%
2 1.0%
3 1.4%
4 1.9%
5-10 2.7%



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