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A Practical Guide to Haemostasis


Atrial Fibrillation [AF]:
Risk Assessment Algorithms - Bleeding

Introduction

A number of risk assessment algorithms have been developed to predict the risk of bleeding in an individual with Atrial Fibrillation and in whom anticoagulation is planned.  These are summarised below:

The ABH Score


The ABH score is a clinical prediction rule for assessing the bleeding risk in patients with Atrial Fibrillation [AF] treated with a DOAC.  In the initial score, 10 variables were analysed - see below. A simplified version of the score was subsequently developed using three variables: Age,  a history of bleeding and non-bleeding related hospitalisation in the preceding 12 months - see ABH Score - Simplified.

Click HERE to access the ABH Score - Original and HERE to access the ABH Score - Simplified.

The ABS Score


The ABS [Anticoagulation-specific Bleeding Score] Algorithm was developed to stratify the risk of bleeding in patients with Atrial Fibrillation on a DOAC [- Dabigatran, Rivaroxaban or Apixaban] or Warfarin.  The model involves the use of 15 variables.

Click HERE for additional information on the ABS algorithm.


ATRIA Bleeding Score


The ATRIA Bleeding Score score is a clinical prediction rule for estimating the risk of bleeding in a patient about to commence anticoagulation with warfarin. 

Click HERE to access the ATRIA Bleeding algorithm.


HAS-BLED Score


The HAS-BLED Score is a clinical prediction rule for estimating the risk of major bleeding in patients with non-valvular Atrial Fibrillation [AF] on warfarin.

Click HERE to access the HAS-BLED Score.


HAEMORR22HAGES Score


The HEMORR2HAGES algorithm is a risk assessment model designed to quantify the risk of haemorrhage in patients with Atrial Fibrillation over the age of 75 years. 

Click HERE to access the HEMORR2HAGES algorithm.



ORBIT-AF Bleeding Score


The ORBIT-AF Bleeding Score [Outcomes Registry for Better Informed Treatment of Atrial Fibrillation] is used to assess bleeding risk in patients with Atrial Fibrillation [AF on anticoagulation with with oral anticoagulants. .

Click HERE to access the ORBIT-AF Score.

The ABC Bleeding Score


The ABC [Age/Biomarkers/Clinical History] Score is an algorithm for the prediction of major bleeding events that incorporates two clinical risk factors and three biomarkers.

Click HERE to access the ABC Score.


The SAMe-TT2R2 score


The SAMe-TT2R2 score was originally devised as a system for identifying individuals with Atrial Fibrillation in whom poor anticoagulation control was likely to be a problem.  It was subsequently evaluated in patients with acute VTE to establish whether individuals with a SAMe-TT2R2 score that would predict poor anticoagulant control with a Vitamin K antagonist e.g. Warfarin would  be more effectively treated with a DOAC.

Click HERE to access the SAMe-TT2R2 algorithm.