Major bleeding - one or more of the following:
(1) any intracranial hemorrhage
(2) bleeding requiring transfusion of >= 2 units of packed RBCs
(3) absolute drop in hematocrit >= 12%
Parameters:
(1) age of the patient in years
(2) renal function
(3) gender
(4) body weight
|
Parameter
|
Finding
|
Points
|
|
age of the patient in years
|
< 65 years of age
|
0
|
|
|
65 - 74 years of age
|
1
|
|
|
>= 75 years of age
|
3
|
|
renal function
|
normal
|
0
|
|
|
insufficiency
|
1
|
|
gender
|
male
|
0
|
|
|
female
|
1
|
|
body weight
|
not significantly decreased
|
0
|
|
|
significantly decreased (>= 15 kilograms)
|
1
|
where:
• The point assignment is based on dividing the odds ratios in Table 3 (page 3112) by 4 and rounding to the nearest integer.
risk score for excess dosing of a glycoprotein IIb/IIIa inhibitor =
= SUM(points for all 4 factors)
Interpretation:
• minimum risk score: 0
• maximum risk score: 6
• The higher the score the greater the risk of an excessive dose of the glycoprotein IIb/IIIa inhibitor.
The risk of major bleeding was increased with:
(1) excessive dose of glycoprotein IIb/IIIa inhibitor
(2) excessive dosing of heparin or other anticoagulant/antiplatelet agent
The risk of major bleeding was greatest when both factors were present.
