🩸 IMPROVE Bleeding Risk Score
UseThe IMPROVE bleeding score stratifies major-bleeding risk in medical inpatients.
Strata<7 lower bleeding risk;≥7 higher major-bleeding risk. [Pending update] Some thresholds, grades and management…
LimitsNot a diagnosis or disposition decision on its own. · Interpret with history, examination and other tests. · For licensed clinicians; does not replace clinical judgement.
SourceDecousus H, et al. Chest 2011. doi:10.1378/chest.09-3081 (IMPROVE bleeding)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adult medical inpatients who need a VTE risk assessment. Suspected DVT follows the diagnostic path only; this page does not make prophylaxis decisions.
- Who it is not for
- Treatment duration for confirmed VTE is not this prophylaxis card. Acute PE is not handled on the prophylaxis card.
- Formula and variables
- Padua is the entry for medical VTE risk assessment. IMPROVE bleed assesses bleeding risk. Caprini is the surgical entry. IMPROVE VTE does not replace Padua. Wells DVT serves only the diagnostic path. Thresholds stay as on this page. The formula is not changed.
- Result → next step
- Next for prevention is the medical VTE risk page: whether and how to give prophylaxis follows current guidelines and local protocol, with bleeding risk assessed. Next for diagnosis is the DVT pathway, which does not involve prophylaxis decisions. This page gives no medication or dose information.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.Medical VTE prophylaxis →
- Guideline
- China PTE guideline 2018
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
<7 lower bleeding risk; ≥7 higher major-bleeding risk.
When to use
The IMPROVE bleeding score stratifies major-bleeding risk in medical inpatients.
How it works
Age (≥85 +3.5; 40–84 +1.5) + male +1 + active ulcer +4.5 + bleed in prior 3 mo +4 + platelets <50 +4 + hepatic failure (INR>1.5) +2.5 + GFR (30–59 +1; <30 +2.5) + ICU/CCU +2.5 + CVC +2 + rheumatic disease +2 + current cancer +2.
Key points
- <7 lower bleeding risk; ≥7 higher major-bleeding risk.
- GFR 30–59 +1; <30 +2.5.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 70 years |
|---|---|
| Sex | Male (+1) |
| GFR (mL/min/1.73m²) | 30–59 (+1) |
| Active gastroduodenal ulcer | No |
| Bleeding in 3 months before admission | No |
| Platelet count <50×10⁹/L | No |
| Hepatic failure (INR >1.5) | No |
| ICU/CCU stay | No |
| Central venous catheter | No |
| Rheumatic disease | No |
| Current cancer | No |
→IMPROVE3.5pts · Lower bleeding risk
- Bands：<7 lower bleeding risk; ≥7 higher major-bleeding risk.
- GFR：≥60 → 0; 30–59 → +1; <30 → +2.5.
- Source：Decousus H, et al. Chest 2011;139:69–79 (PMID 20453069)
| Age | 70 years |
|---|---|
| Sex | Male (+1) |
| GFR (mL/min/1.73m²) | ≥60 |
| Active gastroduodenal ulcer | No |
| Bleeding in 3 months before admission | No |
| Platelet count <50×10⁹/L | No |
| Hepatic failure (INR >1.5) | No |
| ICU/CCU stay | No |
| Central venous catheter | No |
| Rheumatic disease | No |
| Current cancer | No |
→IMPROVE2.5pts · Lower bleeding risk
- Bands：<7 lower bleeding risk; ≥7 higher major-bleeding risk.
- GFR：≥60 → 0; 30–59 → +1; <30 → +2.5.
- Source：Decousus H, et al. Chest 2011;139:69–79 (PMID 20453069)
Verification & sources · governance
FAQ
Frequently asked questions
- Does IMPROVE Bleeding Risk Score upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.