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

Détails

ID Serval
serval:BIB_02BEA0E08145
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Scores to predict major bleeding risk during oral anticoagulation therapy: a prospective validation study.
Périodique
American Journal of Medicine
Auteur(s)
Donzé J., Rodondi N., Waeber G., Monney P., Cornuz J., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Statut éditorial
Publié
Date de publication
2012
Volume
125
Numéro
11
Pages
1095-1102
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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
Création de la notice
12/09/2012 10:35
Dernière modification de la notice
20/08/2019 12:24
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