The IMPROVEDD score is the IMPROVE score modified to include the plasma D-Dimer concentration. This can help to identify an acutely ill inpatient who may benefit from extended thromboprophylaxis. The authors are from multiple institutions in the United States, Canada and England.
Parameters:
(1) immobilization
(2) history of thromboembolism
(3) age of the patient in years
(4) current cancer
(5) known thrombophilia
(6) ICU or CCU stay
(7) lower limb paralysis
(8) plasma D-dimer in ng/mL
(9) upper limit of normal for plasma D-dimer in ng/mL
Parameter from IMPROVE
Finding
Points
immobilization
none or < 7 days
0
>= 7 days
1
history of thromboembolism
no
0
yes
3
age of the patient in years
<= 60 years of age
0
> 60 years of age
1
current cancer
no
0
yes
2
known thrombophilia
no
0
yes
2
ICU or CCU stay
no
0
yes
1
lower limb paralysis
no
0
yes
2
The additional parameter
Parameter
Finding
Points
plasma D dimer
< 2 * ULN
0
>= 2 * ULN
2
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score for original IMPROVE: 12
• maximum score for IMPROVEDD: 14
• A score >= 2 had a greater VTE risk.
Performance:
• The area under the ROC curve is 0.62 (marginal).
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