Patient selection: anticoagulation with a vitamin K antagonist
Parameters:
(1) sex (S)
(2) age in years (A)
(3) medical history (Me): hypertension, diabetes mellitus, coronary artery disease/AMI, peripheral arterial disease, congestive heart failure, previous stroke, pulmonary disease, hepatic disease, renal disease
(4) treatment (T)
(5) tobacco use within past 2 years (T2, for 2 points)
(6) race (R2, for 2 points)
|
Parameter
|
Finding
|
Points
|
|
sex
|
male
|
0
|
|
|
female
|
1
|
|
age in years
|
< 60 years
|
1
|
|
|
>= 60 years
|
0
|
|
medical history
|
0 or 1 condition
|
0
|
|
|
2 or more conditions
|
1
|
|
treatment
|
interacting drug
|
1
|
|
|
no interacting drug
|
0
|
|
tobacco use
|
no
|
0
|
|
|
yes
|
2
|
|
race
|
white
|
0
|
|
|
nonwhite
|
2
|
where:
• Amiodarone is given as an example of an interacting drug.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• Patients with a score of 0 or 1 tend to do well on anticoagulation.
• Patients with scores >= 2 require additional interventions to achieve acceptable control while on anticoagulation.
Performance:
• The area under the ROC curve is 0.72.
