O'Brien et al reported the ORBIT bleeding score as a bedside score to determine the bleeding risk for a patient with atrial fibrillation. The authors are from Duke University, Boston University, Mayo Clinic, Hofstra North Shore, Jefferson Medical College, Stanford University, Janssen Scientific Affairs and UCLA.
ORBIT-AF is the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. ORBIT is also an acronym for the 5 parameters of the score.
Patient selection: atrial fibrillation on oral anticoagulants
Outcome: major bleeding within 2 years
Parameters:
(1) older age (O)
(2) reduce hemoglobin or anemia (R)
(3) bleeding history (B)
(4) insufficient kidney function (I)
(5) treatment with antiplatelet drugs )T)
|
Parameter |
Finding |
Points |
|
age in years |
< 75 years |
0 |
|
|
>= 75 years |
1 |
|
anemia |
absent |
0 |
|
|
present (hemoglobin < 13 g/dL for males; < 12 g/dL for females) |
2 |
|
bleeding history |
absent |
0 |
|
|
present |
2 |
|
renal insufficiency |
absent |
0 |
|
|
present |
1 |
|
antiplatelet therapy |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of bleeding.
|
Total Score |
Risk of Bleeding |
Bleeding per 100 Person Years |
|
0 or 2 |
low |
2.4 |
|
3 |
moderate |
4.7 |
|
4 to 7 |
high |
8.1 |
Performance:
• The area under the ROC curve was 0.67.
Purpose: To evaluate a patient suspected of having a deep vein thrombosis of the upper extremity using the clinical prediction score of Constans et al.
Specialty: Hematology Oncology, Clinical Laboratory, Pharmacology, clinical
Objective: severity, prognosis, stage
ICD-10: I48,
