From: Preventive strategies for hypercoagulation in Cushing’s syndrome: when and how
Score | When to use | Variable – point(s) | Interpretation |
---|---|---|---|
HAS-BLED Score37 | Patients with atrial fibrillation | Hypertension – 1 Abnormal liver/renal function – 1/2 Stroke history – 1 Bleeding predisposition – 1 Labile INR – 1 Elderly (age > 65 years) – 1 Drug/alcohol usage − 1/2 | ≤ 1 (low risk) – anticoagulation should be considered |
2 (moderate risk) – anticoagulation can be considered | |||
3–5 (high risk) and > 5 (very high risk) – alternatives to anticoagulation should be considered | |||
HEMORR2HAGES Score38 | Elderly patients with atrial fibrillation | Hepatic or renal disease – 1 Ethanol abuse – 1 Malignancy – 1 Older (age > 75 years) – 1 Reduced platelet count or function – 1 Rebleeding (prior bleed) – 2 Hypertension (uncontrolled) – 1 Anemia – 1 Genetic factors (CYP2C9 SNP) – 1 Excessive fall risk – 1 Stroke – 1 | ≤ 1 (low risk) – consider anticoagulation if clinically indicated |
2–3 (intermediate risk) – consider alternatives to anticoagulation unless strong indications for it exists | |||
≥ 4 (high risk) – alternative options should often be considered | |||
ATRIA Bleeding Risk Score39 | Patients in whom warfarin anticoagulation is being considered | Anemia – 3 Severe renal disease/Dialysis – 3 Age ≥ 75 years – 2 Prior hemorrhage – 1 Hypertension – 1 | < 4 points (low risk) – reasonable to start warfarin |
4 points (intermediate risk) – alternatives to warfarin therapy can be considered | |||
> 4 points (high risk) – alternatives to warfarin should be strongly considered | |||
ORBIT Score40 | Patients with atrial fibrillation | Anemia – 2 Age > 74 years – 1 Bleeding history – 1 GFR < 60 mL/min/1.73 m2 – 1 Treatment with antiplatelet agents – 1 | ≤ 2 (low risk) 3 (medium risk) 4–7 (high risk) Doesn´t make any recommendation regarding the use or not of hypocoagulation |