Key result
HAS-BLED and ORBIT scores predict major bleeding with similar moderate accuracy in DOAC-treated Asian NVAF patients.
Why the study?
The study aimed to evaluate and compare the performance of HAS-BLED and ORBIT scores in predicting bleeding risk among Asian patients with nonvalvular atrial fibrillation receiving direct-acting oral anticoagulants.
Does the HAS-BLED score predict major bleeding better than the ORBIT score in Asian patients with NVAF receiving DOACs?
Cohort (n=961)
Yes
Does the HAS-BLED score predict major bleeding better than the ORBIT score in Asian patients with NVAF receiving DOACs?
Both HAS-BLED and ORBIT scores offer moderate and comparable predictive performance for major bleeding in Asian patients with NVAF treated with DOACs.
Answers are grounded in this paper and cite their sources.
Comparable moderate performance warrants caution relying on either score alone; leaves open need for Asian-specific bleeding predictors in DOAC-treated NVAF.
AIMS: This study aimed to evaluate the performance of HAS-BLED and ORBIT scores in predicting bleeding risk among Asian patients with nonvalvular atrial fibrillation (NVAF) using direct-acting oral anticoagulants (DOACs). METHODS: A retrospective chart review was conducted among adult patients receiving DOACs for ≥6 months during January 2013 to December 2017 in 10 tertiary care hospitals in Thailand. The area under the receiver operating curve (AUROC) method or C-statistic was used to test the diagnostic accuracy for bleeding risk classification of HAS-BLED and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. RESULTS: A total of 961 NVAF patients, 52.5% warfarin-naïve and 47.5% warfarin-experienced, with mean age of 74.25 ± 10.08 years, were included in the analysis. Mean HAS-BLED and ORBIT scores of the cohort were 1.98 ± 1.10 and 2.37 ± 1.71, respectively. During the mean follow-up time of 1.55 ± 1.13 years, 34 patients experienced major bleeding (2.28 events/100 patient-year). For the overall cohort, both the HAS-BLED and ORBIT scores showed similarly moderate predictive performance on bleeding with C-statistic (95% confidence interval) of 0.65 (0.57-0.74) and 0.64 (0.56-0.71), respectively. There was no statistical significance between the two scores (P = .62). Analysis based on the status of previous warfarin use was consistent with the overall cohort. Based on the calibration analysis, both HAS-BLED and ORBIT scores possessed moderate ability to identify those who experienced major bleeding from those who did not. CONCLUSION: Both HAS-BLED and ORBIT bleeding risk scores had moderate predictive performance in Asian NVAF patients receiving DOACs.
No takes yet. Share an insight, caveat, or question.
Wattanaruengchai et al. (2021) conducted a cohort in nonvalvular atrial fibrillation (NVAF) (n=961). HAS-BLED score vs. ORBIT score was evaluated on major bleeding (predictive performance) (C-statistic, 95% CI 0.57-0.74, p=0.62). The HAS-BLED and ORBIT scores showed similarly moderate predictive performance for major bleeding in Asian NVAF patients on DOACs (C-statistic 0.65 vs 0.64; P=0.62).
Synapse has enriched 10 related papers. Consider them for comparative context: