MDCalc

IMPEDE-VTE

Predicts risk of venous thromboembolism in multiple myeloma.

This tool can be used to identify those patients with multiple myeloma who are at high risk of venous thromboembolism (VTE). Make sure you know your patient’s medication history, VTE history, and fracture history to utilize this score.

Immunomodulatory drug use

BMI ≥25 kg/m2

Pelvic, hip, or femur fracture

Erythropoiesis-stimulating agent

Doxorubicin use

Dexamethasone use

Ethnicity/race is Asian/Pacific Islander

History of VTE before MM

Tunneled line/central venous catheter

Existing thromboprophylaxis: therapeutic LMWH or warfarin use

Existing thromboprophylaxis: prophylactic LMWH or aspirin use

Result:

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Management
  • Consider VTE prophylaxis in patients who are high risk (IMPEDE-VTE score of ≥8) for VTE.
  • While some guidelines (such as the 2022 NCCN Guidelines) suggest a cutoff of ≥4 for high-risk, primary and validation literature of the IMPEDE-VTE score utilize a cutoff of ≥8 for high risk. Be sure to know the standard of care for your practice area.

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