ATRIA Bleeding Risk Score
Determines bleeding risk for patients being considered for warfarin anticoagulation
作成者
Dr. Daniel Singer, MDMales: Hemoglobin <13 g/dL
Females: Hemoglobin <12 g/dL
The ATRIA Bleeding Risk Score considers major and minor risk of hemorrhage and bleeding in patients prior to beginning warfarin therapy.
The ATRIA study included patients with non-valvular, non-transient atrial fibrillation.
Major hemorrhage was defined as fatal, requiring transfusion of ≥2 units pRBCs, or hemorrhage into critical anatomic site (intracranial, retroperitoneal, etc.)
Criteria
Risk Factor | Point Value |
Anemia | 3 |
Severe Renal Disease/Dialysis | 3 |
Age ≥75 | 2 |
Prior Hemorrhage | 1 |
Hypertension | 1 |
Results
Risk Level | Points | Annual Risk of Hemorrhage | Recommendation |
Low Risk | <4 | 0.76% | Reasonable to start warfarin therap |
Intermediate Risk | 4 | 2.6% | Alternatives to warfarin therapy can be considered |
High Risk | >4 | 5.8% | Alternatives to warfarin therapy ought to be strongly considered |
すべての質問と考えられる結果
Questionsタイトルは非表示です
Anemia
Males: Hemoglobin <13 g/dL
Females: Hemoglobin <12 g/dL
Select one option:
- No
- Yes
Severe Renal Disease
Glomerular filtration rate <30mL/min or dialysis-dependent
Select one option:
- No
- Yes
Age ≥ 75 years
Select one option:
- No
- Yes
Any Prior Hemorrhage Diagnosis
Example: GI bleed or intracranial hemorrhage
Select one option:
- No
- Yes
Hypertension History
Select one option:
- No
- Yes
考えられる結果
High Risk (>4 points): Alternatives to warfarin therapy ought to be strongly considered
5.8% Annual Risk of Hemorrhage
- Carefully weigh patient specific risks and benefits of long-term warfarin therapy.
- The ATRIA risk score is one of several tools to stratify the risk of major hemorrhage in patients being considered for warfarin anticoagulation. The HAS-BLED score is another tool that may have a better prediction accuracy than ATRIA.
Low Risk (<4 points): Reasonable to start warfarin therapy
0.76% Annual Risk of Hemorrhage
- Carefully weigh patient specific risks and benefits of long-term warfarin therapy.
- The ATRIA risk score is one of several tools to stratify the risk of major hemorrhage in patients being considered for warfarin anticoagulation. The HAS-BLED score is another tool that may have a better prediction accuracy than ATRIA.
Intermediate Risk (4 points): Alternatives to warfarin therapy can be considered
2.6% Annual Risk of Hemorrhage
- Carefully weigh patient specific risks and benefits of long-term warfarin therapy.
- The ATRIA risk score is one of several tools to stratify the risk of major hemorrhage in patients being considered for warfarin anticoagulation. The HAS-BLED score is another tool that may have a better prediction accuracy than ATRIA.
文献
A new risk scheme to predict warfarin-associated hemorrhage: The ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011 Jul 19;58(4):395-401.
https://www.jacc.org/doi/10.1016/j.jacc.2011.03.031?articleid=1146658Predictive value of the HAS-BLED and ATRIA bleeding scores for the risk of serious bleeding in a "real-world" population with atrial fibrillation receiving anticoagulant therapy. Chest. 2013 Jan;143(1):179-184.
https://pubmed.ncbi.nlm.nih.gov/22722228/Evaluation of the HAS-BLED, ATRIA, and ORBIT Bleeding Risk Scores in Patients with Atrial Fibrillation Taking Warfarin. Am J Med. 2016 Jun;129(6):600-7.
https://pubmed.ncbi.nlm.nih.gov/26482233/
- 作成者
- 提供元
EVAL Foundation
- 寄稿者 · 査読者
Jennifer Glen, DNP, FNP-BCEVAL Health, Chief Medical Officer EVAL Foundation
関連する評価
HAS-BLED Score for Major Bleed Risk
Estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in atrial fibrillation care
Dr. Ron Pisters, MD, PhDCHA2DS2-VASc Score for Atrial Fibrillation Stroke Risk
Calculates stroke risk for patients with atrial fibrillation.
Anticoagulation ForumHEMORR2HAGES Score For Major Bleeding
Quantifies risk of hemorrhage in elderly patients with AFib
Brian F. Gage, MD, MScAspirin Deprescribing Guidelines
Patient-specific recommendations to change or discontinue aspirin that may lead to fewer adverse events
Simplified PESI (Pulmonary Embolism Severity Index: sPESI)
Estimates the 30-day mortality risk following acute pulmonary embolism.
OSU Center for Health SciencesVenous Thromboembolism Evaluation & Management in the Emergency Department
App for the evaluation, diagnosis, & management of ED patients with VTE to stratify for In- vs. Out-patient treatment.
OSU Center for Health SciencesOSU Peripheral Arterial Disease (PAD) Screening Tool
Assess & Diagnosis PAD in the Outpatient Setting
OSU Center for Health SciencesCreatinine Clearance (Cockcroft-Gault Equation)
Calculates CrCl using the Cockcroft-Gault Equation
Dr. Donald W. Cockcroft, MDISTH-SSC Bleeding Assessment Tool (ISTH-SCC BAT)
Evaluates bleeding symptoms in patients with inherited bleeding disorders.
Dr. Francesco Rodeghiero, M.D.EVAL Foundation の他の評価
Alcohol Use Disorders Identification Test - C (AUDIT-C)
A 3-item tool to screen for unhealthy alcohol use in patients who may not be alcohol-dependent.
Dr. Katharine Bradley, MD, MPHAlcohol Use Disorders Identification Test (AUDIT)
A 10-item tool to screen for hazardous alcohol use, harmful use, and alcohol dependence.
World Health Organization Collaborative ProjectAmerican Shoulder and Elbow Surgeons (ASES) Shoulder Score
15-item assessment of shoulder pain and functional limitations in activities of daily living.
Dr. Robin R. Richards, MD, FRCSC, FAAOS, FAOABehavioral Activity Rating Scale (BARS)
A 1-item rating scale to quantify a patient's level of agitation in acute care or psychiatric settings.
Drug Abuse Screening Test (DAST-10)
A patient self-report questionnaire to screen for problematic drug use (excluding alcohol/tobacco).
Dr. Harvey A. Skinner, Ph.D.Foot and Ankle Ability Measure (FAAM)
Assesses functional limitations and disability related to foot and ankle conditions in daily activities and sports.
Dr. Jesse Van Swearingen, PhD, PT, FAPTAFoot and Ankle Disability Index (FADI)
Assess functional limitations of those with a variety of foot and ankle conditions
Dr. RobRoy Martin, PhD, PT, CSCSGeneral Anxiety Disorder (GAD-7)
Measure severity of anxiety
Dr. Robert L. Spitzer, MD