ATRIA Bleeding Risk Score
Determines bleeding risk for patients being considered for warfarin anticoagulation
创建者
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 |
所有问题及可能的结果
Questions标题不可见
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
可能的结果
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/
- 创建者
- 提供方
EVAL Foundation
- 贡献者 · 审核者
Jennifer Glen, DNP, FNP-BCEVAL Health, Chief Medical Officer EVAL Foundation
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