Patient selection: patient with atrial fibrillation in the ED
Outcome: 30-day mortality or cardiovascular hospitalization
Parameters:
(1) age in years, per decade increase
(2) serum troponin
(3) INR
(4) anticoagulation therapy
(5) HAS-BLED score
(6) serum creatinine in µmol/L
(7) evidence of heart failure
(8) given furosemide in the ED
(9) history of COPD
(10) history of major cancer (exclusion of minor skin cancers)
(11) history of dementia
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
10 per decade increase
|
|
serum troponin
|
negative
|
0
|
|
|
positive
|
41
|
|
INR
|
<2
|
6
|
|
|
2 to 3
|
0
|
|
|
> 3
|
37
|
|
anticoagulation therapy
|
no
|
39
|
|
|
yes
|
0
|
|
HAS-BLED score
|
< 3
|
0
|
|
|
>= 3
|
13
|
|
serum creatinine
|
<= 200 µmol/L
|
0
|
|
|
> 200 µmol/L
|
49
|
|
heart failure
|
no
|
0
|
|
|
yes
|
28
|
|
furosemide in ED
|
no
|
0
|
|
|
yes
|
42
|
|
history of COPD
|
no
|
0
|
|
|
yes
|
22
|
|
history of major cancer
|
no
|
0
|
|
|
yes
|
22
|
|
history of dementia
|
no
|
0
|
|
|
yes
|
24
|
where:
• The handling of age is a little ambiguous. One might assume this to be INT((age)/10). However, in the TrOPs-BAC score a score < 65 years is given 0 points. This would mean that 65 to 74 is 10, 75 to 84 is 20, 85 to 94 is 30 and so on.
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 377
|
Score Quintiles
|
30-Day Mortality or Cardiovascular Hospitalization
|
|
<= 60
|
2%
|
|
61 to 80
|
5.7 to 6.6%
|
|
81 to 98
|
4.9 to 10.7%
|
|
99 to 126
|
10.6 to 12.5%
|
|
>= 127
|
20 to 23.8%
|
