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 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 [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.
The ATRIA Bleeding 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.
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.
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.
The ORBIT Bleeding Score is used to assess bleeding risk in patients with Atrial Fibrillation [AF] on anticoagulation with oral anticoagulants.
Click HERE to access the ORBIT 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 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.
The score was developed using data from RE-LY trail [Randomised Evaluation of Long-Term Anticoagulation Therapy], further developed using data in the GARFIELD-AF registry [Global Anticoagulant Registry in
the Field-Atrial Fibrillation] and then validated using the COMBINE-AF trials [A Collaboration Between Multiple Institutions to Better Investigate
Non-Vitamin K Antagonist
Oral Anticoagulant Use in Atrial
Fibrillation] and individuals
in the Quebec Régie de l’Assurance Maladie du
Québec and Med-Echo Administrative Databases
(RAMQ) administrative database.
The DOAC score was developed using data from the RE-LY study and in which patients received Dabigatran 150mg twice daily. The score was then refined using data from the GARFIELD-AF registry with patients on all DOACs - Apixaban, Edoxaban and Rivaroxaban.
Click HERE to access the DOAC Score.
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