IMPROVE and IMPROVEDD scores for venous thromboembolism: Difference between revisions
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'''''To see a risk calculator according to IMPROVEDD scores, click [[IMPROVEDD risk score calculator|here]]'''.'' | '''''To see a risk calculator according to IMPROVEDD scores, click [[IMPROVEDD risk score calculator|here]]'''.'' | ||
'''''To see a risk calculator according to IMPROVE scores, click [[IMPROVE VTE risk score|here]]'''.'' | |||
==Overview== | ==Overview== | ||
The IMPROVE score for [[venous thromboembolism]] ([[VTE]]) assesses the risk of [[Venous thromboembolism|VTE]] among hospitalized medical patients. The IMPROVE predictive score for [[Venous thromboembolism|VTE]] includes 4 independent risk factors for [[VTE]] which are present at admission. The IMPROVE associative score for [[Venous thromboembolism|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 [[Venous thromboembolism|VTE]] was not available. | The IMPROVE score for [[venous thromboembolism]] ([[VTE]]) assesses the risk of [[Venous thromboembolism|VTE]] among hospitalized medical patients. The IMPROVE predictive score for [[Venous thromboembolism|VTE]] includes 4 independent risk factors for [[VTE]] which are present at admission. The IMPROVE associative score for [[Venous thromboembolism|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 [[Venous thromboembolism|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 | ==IMPROVE-DD score for VTE risk stratification== | ||
===Calculation of the | The IMPROVEDD [[Venous thromboembolism|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.<ref name="IMPROVEDD">{{cite journal|title=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}}</ref> | ||
===Calculation of the IMPROVEDD Associative Score=== | |||
{| style="cellpadding=0; cellspacing= 0; width: 600px;" | {| style="cellpadding=0; cellspacing= 0; width: 600px;" | ||
|- | |- | ||
| 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=" | | 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="IMPROVEDD" /> | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | Prior episode of [[VTE]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | 3 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | Prior episode of [[VTE]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | 3 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Thrombophilia]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Thrombophilia]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[ | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Paralysis]] of the [[lower extremity]] during the hospitalization|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Current [[malignancy]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style=" | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[D-dimer]] ≥ 2x Upper Limit of Normal (ULN)|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Immobilization for at least 7 days|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[ICU]] or [[CCU]] admission|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Age more than 60 years|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1 | ||
|} | |} | ||
== | ===Interpretation of the IMPROVEDD Associative Score=== | ||
{| style="cellpadding=0; cellspacing= 0; width: 600px;" | {| style="cellpadding=0; cellspacing= 0; width: 600px;" | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | ''' | | style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Score'''|| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Predicted VTE risk through 42 days'''<ref name="IMPROVEDD" /> | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | 0|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.4% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.6% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.8% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.2% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.6% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |5-10|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.2% | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | |||
|} | |} | ||
{| style="cellpadding=0; cellspacing= 0; width: 600px;" | {| style="cellpadding=0; cellspacing= 0; width: 600px;" | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Score'''|| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Predicted VTE risk through | | style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Score'''|| style="padding: 0 5px; font-size: 100%; background: #F5F5F5;" align="center" | '''Predicted VTE risk through 77 days'''<ref name="IMPROVEDD" /> | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | 0|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0. | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | 0|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.5% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0. | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.7% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.0% | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.0% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1. | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.4% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.9% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |5-10|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |7 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |5-10|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.7% | ||
|} | |} | ||
==IMPROVE | ==IMPROVE Associative Score for VTE== | ||
IMPROVE associative risk score assesses the risk of [[Venous thromboembolism|VTE]] among hospitalized medical patients. While the IMPROVE predictive score includes 4 independent risk factors for [[Venous thromboembolism|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 [[Venous thromboembolism|VTE]] is not available.<ref name="pmid21436241">{{cite journal| author=Spyropoulos AC, Anderson FA, Fitzgerald G, Decousus H, Pini M, Chong BH et al.| title=Predictive and associative models to identify hospitalized medical patients at risk for VTE. | journal=Chest | year= 2011 | volume= 140 | issue= 3 | pages= 706-14 | pmid=21436241 | doi=10.1378/chest.10-1944 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21436241 }} </ref> | |||
===Calculation of the IMPROVE Associative Score=== | ===Calculation of the IMPROVE Associative Score=== | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Thrombophilia]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Thrombophilia]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Paralysis of the lower extremity during the hospitalization|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |[[Paralysis]] of the [[lower extremity]] during the hospitalization|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Current [[malignancy]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Current [[malignancy]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2 | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Immobilization for at least 7 days|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |Immobilization for at least 7 days|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1 | ||
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|} | |} | ||
===Interpretation of the | ===Interpretation of the IMPROVE Associative Score=== | ||
{| style="cellpadding=0; cellspacing= 0; width: 600px;" | {| style="cellpadding=0; cellspacing= 0; width: 600px;" | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.6% | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0.6% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |0 | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.0% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1. | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |3|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |1.7% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2.9% | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |5-10|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |5-10|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |7.2% | ||
|} | |} | ||
Latest revision as of 05:46, 10 February 2019
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
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
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
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
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
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
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
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
- ↑ 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.
- ↑ 2.0 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.