Scores to predict major bleeding risk during oral anticoagulation therapy: a prospective validation study.

Details

Serval ID
serval:BIB_02BEA0E08145
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Scores to predict major bleeding risk during oral anticoagulation therapy: a prospective validation study.
Journal
American Journal of Medicine
Author(s)
Donzé J., Rodondi N., Waeber G., Monney P., Cornuz J., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Publication state
Published
Issued date
2012
Volume
125
Number
11
Pages
1095-1102
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Clinical scores may help physicians to better assess the individual risk/benefit of oral anticoagulant therapy. We aimed to externally validate and compare the prognostic performance of 7 clinical prediction scores for major bleeding events during oral anticoagulation therapy.
METHODS: We followed 515 adult patients taking oral anticoagulants to measure the first major bleeding event over a 12-month follow-up period. The performance of each score to predict the risk of major bleeding and the physician's subjective assessment of bleeding risk were compared with the C statistic.
RESULTS: The cumulative incidence of a first major bleeding event during follow-up was 6.8% (35/515). According to the 7 scoring systems, the proportions of major bleeding ranged from 3.0% to 5.7% for low-risk, 6.7% to 9.9% for intermediate-risk, and 7.4% to 15.4% for high-risk patients. The overall predictive accuracy of the scores was poor, with the C statistic ranging from 0.54 to 0.61 and not significantly different from each other (P=.84). Only the Anticoagulation and Risk Factors in Atrial Fibrillation score performed slightly better than would be expected by chance (C statistic, 0.61; 95% confidence interval, 0.52-0.70). The performance of the scores was not statistically better than physicians' subjective risk assessments (C statistic, 0.55; P=.94).
CONCLUSION: The performance of 7 clinical scoring systems in predicting major bleeding events in patients receiving oral anticoagulation therapy was poor and not better than physicians' subjective assessments.
Pubmed
Web of science
Create date
12/09/2012 10:35
Last modification date
20/08/2019 12:24
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