ArticleThe Lancet regional health. Western Pacific2020
Validation of the IMPROVE bleeding risk score in Chinese medical patients during hospitalization: Findings from the dissolve-2 study.
Article in The Lancet regional health. Western Pacific, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Chinese expert consensus on clinical management of hepatopathy-related thrombocytopenia (2023 edition).Hepatology international · 2025Guideline
- Development and validation of risk models for hospital-acquired bleeding in medical inpatients: the Medical Inpatients Thrombosis and Hemostasis (MITH) study.Journal of thrombosis and haemostasis : JTH · 2026Article
- External Validation of the IMPROVE Risk Score for Predicting Bleeding in Hospitalized COVID-19 Patients.Journal of general internal medicine · 2025Article
- Research progress on bleeding risk assessment models in anticoagulant therapy.Frontiers in cardiovascular medicine · 2025Review
- Converting IMPROVE bleeding and VTE risk assessment models into a fast-and-frugal decision tree for optimal hospital VTE prophylaxis.Blood advances · 2024Article
- Validation of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) risk scores for venous thromboembolism and bleeding in an independent population.Research and practice in thrombosis and haemostasis · 2024Article
- Article
- Prediction of bleeding in patients being considered for venous thromboembolism prophylaxis.Journal of vascular surgery. Venous and lymphatic disorders · 2023Article
- Thrombosis and anticoagulation: clinical issues of special importance to hematologists who practice in Asia.Hematology. American Society of Hematology. Education Program · 2022Article
- Preventing venous thromboembolism without causing harm.The Lancet regional health. Western Pacific · 2021Article
- Do Inpatients Receive Risk-Based Prophylactic Treatment for Thrombotic Events?Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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10 authors at 5 institutions in 1 country.
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Abstract
backgroundVenous thromboembolism (VTE) prophylaxis remains suboptimal in China due to the bleeding risk associated with pharmacologic prophylaxis. We used data from the DissolVE-2 study to report the risk factors for bleeding and validated the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) bleeding risk score (BRS).
methodsIn-hospital major bleeding incidence in medical patients from the DissolVE-2 study were assessed by Kaplan-Meier method. Risk factors associated with clinically relevant bleeding (CRB) were analysed using Cox regression model. Sensitivity, specificity, positive predictive value, negative predictive value and receiver-operating characteristic (ROC) curve was used to compute the diagnostic accuracy of IMPROVE BRS in the study cohort.
findingsOf the 6623 medical patients, 5076 patients with all relevant clinical details were included for the validation cohort. Overall, 127 CRB events (38 major and 89 clinically relevant non-major bleeding events) occurred in this cohort, with a cumulative incidence rate of 2.6% (95% confidence interval [CI], 2.3-3.4). Application of IMPROVE BRS revealed significantly higher hazards of CRB (hazard ratio [HR]: 7.17, 95% CI, 5.05-10.18) and major bleeding (HR: 13.95, 95% CI, 7.28-26.73) in patients with IMPROVE BRS ≥7. Comparison of predictive parameters revealed higher sensitivity (44.1 vs 35.9) and positive predictive value (10.9 vs 2.6) for CRB in our study than the IMPROVE study, which was substantiated by the area under the curve (0.73,
interpretationIMPROVE BRS is a simple model for estimating bleeding risk in Chinese medical patients and could be used in conjunction with VTE risk assessment models to decide prophylactic treatment for VTE.
fundingThis study and the additional data analysis were funded by Sanofi (Beijing) Pharmaceutical Co, Ltd by the Fund of The National Key Research and Development Program of China [Grant 2016YFC0905600] and by CAMS Innovation Fund for Medical Sciences (CIFMS) (No.2018-I2M-1-003).
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