II. Indications
- Atrial Fibrillation Anticoagulation (used in combination with CHAD Score)
III. Criteria: 1 point for each
-
Hypertension
- Uncontrolled with systolic Blood Pressure >160 mmHg
- Renal dysfunction
- Serum Creatinine >2.3 mg/dl
-
Liver dysfunction
- Bilirubin >2x normal or
- Alkaline Phosphatase >3x normal
- Liver transaminases (e.g. AST, ALT) >3x normal
- Stroke history
- Bleeding history
- Major bleeding or predisposition
- Bleeding that required hospitalization or
- Bleeding with serious consequences (e.g. Intracranial Hemorrhage) or
- Hemoglobin decrease of >2 g/dl or
- Bleeding that required transfusion
- Labile INRs
- History of over-Anticoagulation
- Elderly
- Age over 65 years old
- Drugs (up to 1 point for meds and 1 point for Alcohol)
- Other Anticoagulants
- Anti-Platelet agents
- NSAIDs
- Alcohol >8 drinks weekly
IV. Interpretation
- Maximum total score: 9
- Risk of major bleeding in one year
- Score 0 points: Major bleeding risk 1% per year
- Score 1 points: Major bleeding risk 3.4% per year
- Score 2 points: Major bleeding risk 4.1% per year
- Score 3 points: Major bleeding risk 5.8% per year
- Score 4 points: Major bleeding risk 8.9% per year
- Score 5 points: Major bleeding risk 9.1% per year
- Score >5 points: Major bleeding risk 12-15% per year