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Age, Biomarkers, Clinical History (ABC) Bleeding Risk Score for Atrial Fibrillation Patient

Purpose: To evaluate a patient with atrial fibrillation for risk of bleeding using the ABC score of Hijazi et al.

Description

Hijazi et al developed the ABC bleeding risk score for predicting major bleeding in a patient with atrial fibrillation who is receiving anticoagulants. This can help to identify a patient who may benefit from more aggressive management or an alternative therapy. The authors are from Uppsala University, Population Health Research Institute (Hamilton, Ontario), Jefferson Medical College and Boston University.


 

Patient selection: atrial fibrillation, treated with apixaban or warfarin

 

Outcome: major bleed

 

Parameters:

(1) age in years from 44 to 90 years of age

(2) serum high-sensitivity cardiac troponin T in ng/L (Cobas, Roche Diagnostics), from 3.3 to 65

(3) hemoglobin in g/dL from 10.5 to 17.9

(4) GDF-15 in ng/L (Elecsys, Roche Diagnostics), from 450 to 7250

(5) history of previous bleed

 

points for age =

= (0.17869 * (age)) – 7.8626

 

points for hemoglobin =

= 12.38 – (0.6917 * (hemoglobin))

 

points for troponin =

= (7.722 * LOG10(tropinin)) – 3.99

 

points for GDF-15 =

= (7.77 * LOG10(GDP)) – 20.62

 

History of Bleeding

Points

no

0

yes

2.1

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 34.8

• The higher the score the greater the risk for bleeding.

 

Score

1 Year Risk of a Major Bleed

< 9

< 1%

9 to 22.4

(0.01661 * ((points)^2)) – (0.2266 * (points)) + 1.713

22.4 to 38.3

(0.07862 * ((points)^2)) – (3.214 * (points)) + 37.63

 

 

Score

3 Year Risk of a Major Bleed

< 7

< 2%

7 to 20.5

(0.05575 * ((points)^2)) – (0.9433 * (points)) + 5.86

20.5 to 40.4

(0.09942 * ((points)^2)) – 3.034 * (points)) + 30.42

 


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Specialty

Objective

ICD-10