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==Overview==
==Overview==
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.


==IMPROVE Bleeding Risk Score==
==IMPROVE Bleeding Risk Score==
===Calculation of the 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><ref name="pmid26867833">{{cite journal |vauthors=Hostler DC, Marx ES, Moores LK, Petteys SK, Hostler JM, Mitchell JD, Holley PR, Collen JF, Foster BE, Holley AB |title=Validation of the International Medical Prevention Registry on Venous Thromboembolism Bleeding Risk Score |journal=Chest |volume=149 |issue=2 |pages=372–9 |date=February 2016 |pmid=26867833 |doi=10.1378/chest.14-2842 |url=}}</ref>


{| style="cellpadding=0; cellspacing= 0; width: 600px;"
==IMPROVE Bleeding Risk Score Calculator==
 
{| class="wikitable"
|-
! colspan="2" |Variable
! Score
|-
| rowspan="3" |Age
| ≥ 85 years
| 3.5
|-
|40-84 years
|1.5
|-
|-
| 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>
|&amp;lt; 40
|0
|-
|-
| 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
| rowspan="2" |Gender
|Male
|1
|-
|-
| 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
|Female
|0
|-
|-
| 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
| rowspan="3" |Kidney function
|Normal kidney function (GFR ≥ 60 mL/min/m<sup>2</sup>)
|0
|-
|-
| 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
|[[Kidney failure|Moderate kidney failure]] ([[GFR]] 30-59 mL/min/m<sup>2</sup>)
|1
|-
|-
| 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
|[[Kidney failure|Severe kidney failure]] ([[GFR]] &amp;lt; 30 mL/min/m<sup>2</sup>)
|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
| rowspan="2" |Liver function
|Normal liver function (INR ≤ 1.5)
|0
|-
|-
| 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
|[[Liver failure]] ([[INR]] &amp;gt; 1.5)
|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
| rowspan="2" |Platelet
|≥ 50x10<sup>9</sup>/L
|0
|-
|-
| 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
|&amp;lt; 50x10<sup>9</sup>/L
|4
|-
|-
| 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
| colspan="2" |Admission to [[ICU]] or [[CCU]]
|2.5
|-
|-
| 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
| colspan="2" |[[Central venous catheter]]
|2
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |Male||style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left |1
| colspan="2" |Active [[gastric ulcer|gastric]] or [[duodenal ulcer]]
|4.5
|-
|-
| 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
| colspan="2" |Prior [[bleeding]] within the last 3 months|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |4
|-
| colspan="2" |Rheumatic disease|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2
|-
| colspan="2" |Active [[malignancy]]|| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align="left" |2
|}
|}
==Interpretation==


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


===Interpretation of the IMPROVE Bleeding Risk Score===
==See also==
 
* [[IMPROVE VTE 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: Elevated risk of bleeding'''
* '''Score <7: Not elevated risk of bleeding'''


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


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Hematology]]
[[Category:Angiology]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
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{{WS}}

Latest revision as of 06:30, 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][2]

IMPROVE Bleeding Risk Score Calculator

Variable Score
Age ≥ 85 years 3.5
40-84 years 1.5
&lt; 40 0
Gender Male 1
Female 0
Kidney function Normal kidney function (GFR ≥ 60 mL/min/m2) 0
Moderate kidney failure (GFR 30-59 mL/min/m2) 1
Severe kidney failure (GFR &lt; 30 mL/min/m2) 2.5
Liver function Normal liver function (INR ≤ 1.5) 0
Liver failure (INR &gt; 1.5) 2.5
Platelet ≥ 50x109/L 0
&lt; 50x109/L 4
Admission to ICU or CCU 2.5
Central venous catheter 2
Active gastric or duodenal ulcer 4.5
Prior bleeding within the last 3 months 4
Rheumatic disease 2
Active malignancy 2

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 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.
  2. Hostler DC, Marx ES, Moores LK, Petteys SK, Hostler JM, Mitchell JD, Holley PR, Collen JF, Foster BE, Holley AB (February 2016). "Validation of the International Medical Prevention Registry on Venous Thromboembolism Bleeding Risk Score". Chest. 149 (2): 372–9. doi:10.1378/chest.14-2842. PMID 26867833.

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