IMPROVE bleeding risk score

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.

The IMPROVE bleeding risk score estimates the risk of bleeding among acutely ill hospitalized patients.^[1]^[2]

Variable		Score
Age	≥ 85 years	3.5
	40-84 years	1.5
	< 40	0
Gender	Male	1
Gender	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 < 30 mL/min/m²)	2.5
Liver function	Normal liver function (INR ≤ 1.5)	0
Liver function	Liver failure (INR > 1.5)	2.5
Platelet	≥ 50×10⁹/L	0
Platelet	< 50×10⁹/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

The IMPROVE risk score for bleeding can be interpreted as such:^[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.
↑ 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.