Subherwal et al developed the CRUSADE bleeding score to identify a patient at risk for major in-hospital bleeding following therapy on non-ST-segment elevation myocardial infarction. The authors are from Washington University, Duke University, University of Cincinnati and Pennsylvania Hospital.
CRUSADE = Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHH guidelines.
Parameters:
(1) baseline hematocrit in percent
(2) estimated creatinine clearance in mL per minute (Cockcroft-Gault)
(3) heart rate in beats per minute
(4) gender
(5) signs of congestive heart failure (CHF) at presentation
(6) history of prior vascular disease (stroke or peripheral artery disease)
(7) history of diabetes mellitus
(8) systolic blood pressure in mm Hg
|
Parameter |
Finding |
Points |
|---|---|---|
|
baseline hematocrit |
< 31% |
9 |
|
|
31.0 to 33.9% |
7 |
|
|
34.0 to 36.9% |
3 |
|
|
37.0 to 39.9% |
2 |
|
|
>= 40% |
0 |
|
creatinine clearance |
<= 15 mL per minute |
39 |
|
|
15.1 to 30 |
35 |
|
|
30.1 to 60 |
28 |
|
|
60.1 to 90 |
17 |
|
|
90.1 to 120 |
7 |
|
|
> 120 mL per minute |
0 |
|
heart rate |
<= 70 beats per minute |
0 |
|
|
71 to 80 |
1 |
|
|
81 to 90 |
3 |
|
|
91 to 100 |
6 |
|
|
101 to 110 |
8 |
|
|
111 to 120 |
10 |
|
|
> 120 |
11 |
|
gender |
male |
0 |
|
|
female |
8 |
|
signs of CHF |
no |
0 |
|
|
yes |
7 |
|
history of vascular disease |
no |
0 |
|
|
yes |
6 |
|
history of diabetes mellitus |
no |
0 |
|
|
yes |
6 |
|
systolic blood pressure |
<= 90 mm Hg |
10 |
|
|
91 to 100 |
8 |
|
|
101 to 120 |
5 |
|
|
121 to 180 |
1 |
|
|
181 to 200 |
3 |
|
|
>= 201 mm Hg |
5 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score 1
• maximum score: 96 points
|
Score |
Percent Major Bleeding |
|---|---|
|
0 to 50 |
(0.002554 * ((points)^2)) + (0.06432 * (points)) + 2.418 |
|
50 to 100 |
(0.005616 * ((points)^2)) - (0.21 * (points)) + 8.579 |
|
0 to 100 |
(0.000020 * ((points)^3)) + (0.001311 * ((points)^2)) + (0.07947 * (points)) + 2.42 |
Purpose: To predict the risk of major bleeding in a patient being treated for non-ST-segment elevation myocardial infarction using the CRUSADE score.
Specialty: Hematology Oncology, Clinical Laboratory, Clinical Pharmacology
Objective: complications, response to therapy, adverse effects
ICD-10: D69, I21,
