期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 217, 期 -, 页码 85-91出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2016.04.173
关键词
Atrial fibrillation; Hemorrhage; Risk; Intracranial hemorrhages; Forecasting
资金
- Bristol-Myers Squibb
- Pfizer
Objective: The HAS-BLED, ATRIA, and HEMORR(2)HAGES risk scores were created to evaluate individual bleedingrisk in atrial fibrillation (AF). We sought to estimate and compare the predictive ability of these scores for major hemorrhage in AF, including elderly (>= 80 years) and non-elderly (<80 years) patients. Methods: This cross-sectional study is based on the French National Hospital Database (PMSI), which covers the entire French population. Data from all patients with an AF diagnosis in 2012 were extracted. Demographic and comorbidity data were used to calculate the three bleeding risk scores for each patient. Patients hospitalized with a principal diagnosis of major bleeding were identified. Results: Of the 533,044 AF patients identified, 53.2% were >= 80 years; 7013 patients (1.3%) were hospitalized for a bleeding event (1785 for intracranial hemorrhage). Bleeding occurred more frequently in patients with higher HAS-BLED, HEMORR(2)HAGES, and ATRIA scores. In patients >= 80 years, the c-statistics did not differ (p = 0.27) between HAS-BLED (0.54; 95% confidence interval [CI]: 0.53-0.54), HEMORR(2)HAGES (0.53; 95% CI: 0.53-0.54), and ATRIA (0.53; 95% CI: 0.52-0.54). In patients <80 years, HAS-BLED (0.59; 95% CI: 0.58-0.60) had a slightly higher c-statistic than HEMORR(2)HAGES (0.56; 95% CI: 0.55-0.57) and ATRIA (0.55, 95% CI: 0.55-0.56) (p < 0.0001). Conclusions: Given its simplicity and similar performance, HAS-BLED may be an attractive alternative to HEMORR2HAGES for estimation of bleeding risk in AF patients < 80 years. However, accurate determination of bleeding risk among the elderly is difficult with existing risk-prediction scores, indicating a clear need for improvement in their clinical utility. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据