Risk Factors of Doepker et al for Bleeding in a Patient in the ICU Anticoagulated with Argatroban

 

Patient selection: ICU patient receiving argatroban

 

Parameters:

(1) major surgery before or during argatroban therapy

(2) dosing weight in kilograms

(3) total serum bilirubin in mg/dL

(4) platelet count

Parameter	Finding	Points
major surgery	no	0
	yes	1
dosing weight	<= 90 kg	0
	> 90 kg	1
total serum bilirubin	< 3 mg/dL	0
	>= 3 mg/dL	1
platelet count	> 70,000 per µL	0
	<= 70,000 per µL	1

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The risk of bleeding increases with the number of risk factors present.

 

The paper assumes that the patient's argatroban dose was adjusted for renal and hepatic function. Failure to reduce the dose for renal or hepatic dysfunction would increase risk of bleeding as well.