Singer et al reported a risk score for evaluating a patient with atrial fibrillation for risk of thromboembolic complications. This can help guide anticoagulant therapy. The authors are from Massachusetts General Hospital, University of California San Francisco, Kaiser Permanente, and Stanford University.
Patient selection: atrial fibrillation
Outcome: ischemic stroke or other thromboembolism
Parameters:
(1) age in years
(2) history of prior stroke
(3) gender
(4) diabetes mellitus
(5) chronic heart failure
(6) hypertension
(7) proteinuria
(8) eGFR mL/min per 1.73 square meter or end-stage renal failure (ESRD)
Parameter
Finding
Points
age in years and history of stroke
< 65 years and no history
0
< 65 years and history
8
65 to 74 years and no history
3
65 to 74 years and history
7
75 to 84 years and no history
5
75 to 84 years and history
7
>= 85 years and no history
6
>= 85 years and history
9
gender
male
0
female
1
diabetes mellitus
absent
0
present
1
chronic heart failure
absent
0
present
1
hypertension
absent
0
present
1
proteinuria
absent
0
present
1
renal function
EGFR >= 45
0
EGFR < 45 or ESRD
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the greater the risk of an adverse outcome.
Total Score
Risk Group
Events per Year
0 to 5
low
< 1%
6
moderate
1 to 1.99%
7 to 15
high
>= 2%
Performance:
• The area under the ROC curve was 0.73 for severe events.
To read more or access our algorithms and calculators, please log in or register.
