haematology general-medicine

IMPROVE-DD VTE Risk Score

Predicts VTE risk in medically ill hospitalised patients. The IMPROVE-DD version adds D-dimer to the original IMPROVE score.

Score interpretation

Low Risk (IMPROVEDD 0–1) 0–1

Symptomatic VTE 0.39 % at 42 days and 0.91 % at 77 days in the derivation cohort — below the 1 % threshold for prophylaxis.

→ Pharmacological prophylaxis not routinely needed; encourage mobilisation and reassess if the clinical picture changes.

At Risk (IMPROVEDD ≥ 2) 2–14

Symptomatic VTE 1.11 % at 42 days and 2.22 % at 77 days (HR 2.73 vs a score of 0–1); risk rises with the score.

→ Pharmacological prophylaxis (LMWH/UFH) unless contraindicated — assess bleeding risk first (e.g. IMPROVE bleeding score).

Interpretation bands for the IMPROVE-DD. Apply clinical judgement and local guidance.

Gibson CM, Spyropoulos AC, Cohen AT, et al. The IMPROVEDD VTE risk score: incorporation of D-dimer into the IMPROVE score to improve venous thromboembolism risk stratification. TH Open. 2017;1(1):e56-e65.
Spyropoulos AC et al. Predictive and associative models to identify hospitalized medical patients at risk for VTE. Chest. 2011;140(3):706-714.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.