Shimomura et al reported a simple score for identifying a patient being treated with oral anticoagulants who is at greater risk of acute gastrointestinal bleeding. The authors are from the National Center for Global Health and Medicine and Kohnodai Hospital in Japan.
Patient selection: receipt of oral anticoagulant
Parameters:
(1) therapy with a proton pump inhibitor
(2) chronic kidney disease
(3) cirrhosis
(4) COPD
(5) history of peptic ulcer disease
Parameter
Finding
Points
proton pump history
no
0
yes
-1
chronic kidney disease
no
0
yes
2
cirrhosis
no
0
yes
2
COPD
no
0
yes
1
peptic ulcer disease
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -1
• maximum score: 6
Total Score
Hazard Ratio GI Bleed
-1
1
0
3.8
1
6.0
2
12.9
3
59
Performance:
• The area under the ROC curve is 0.65.
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