II. Indications
- Bleeding Risk in Atrial Fibrillation Patients on DOACs
- DOAC Score was specifically developed to predict the bleeding risk on DOACs
- Contrast with the HAS-BLED Score, developed to assess bleeding risk with Warfarin
III. Criteria
- Age (select one or none)
- Score 2: Age 65 to 69 years
- Score 3: Age 70 to 74 years
- Score 4: Age 75 to 79 years
- Score 5: Age 80 years or older
-
Creatinine Clearance (eGFR, select one or none)
- Score 1: eGFR 30 to 60 ml/min
- Score 2: eGFR <30 ml/min
- Underweight (select one or none)
- Score 1: BMI <18.5 kg/m2
- Antiplatelet Use (select one or none)
- Score 2: Aspirin
- Score 3: Dual Antiplatelet Agents
- History (select any that apply)
- Score 1: Stroke, TIA or systemic embolism history
- Score 1: Diabetes Mellitus
- Score 1: Hypertension
- Score 1: NSAID Use
- Score 3: Bleeding History
- Score 2: Liver Disease
IV. Interpretation
- Total score tallied from criteria: 0 to 10 (max 10)
- Bleeding Risk based on total score
- Score 0 to 3: Very Low Bleeding Risk
- Major Bleeding Risk at 1 year: 0.8%
- Life-Threatening Bleeding Risk at 1 year: 0.3%
- Score 4 to 5: Low Bleeding Risk
- Major Bleeding Risk at 1 year: 1.6%
- Life-Threatening Bleeding Risk at 1 year: 0.6%
- Score 6 to 7: Moderate Bleeding Risk
- Major Bleeding Risk at 1 year: 3.4%
- Life-Threatening Bleeding Risk at 1 year: 1.4%
- Score 8 to 9: High Bleeding Risk
- Major Bleeding Risk at 1 year: 6.9%
- Life-Threatening Bleeding Risk at 1 year: 2.9%
- Score 10: Very High Bleeding Risk
- Major Bleeding Risk at 1 year: 13.9%
- Life-Threatening Bleeding Risk at 1 year: 6.3%
- Score 0 to 3: Very Low Bleeding Risk