The Alfalfa-Anticoagulant-ICH score, incorporating six clinical factors including leukoaraiosis and fall risk, accurately predicted intracranial hemorrhage in patients using anticoagulants with an AUC of 0.883.
Cohort (n=617)
No
617 patients receiving anticoagulant therapy (indications including AF, VTE, stroke/TIA, arteriosclerosis, peripheral vascular diseases, prosthetic mechanical valve replacement) at a teaching hospital in southern China. Excluded: pregnant/lactating women, severe mental illness, prior intracranial hemorrhage, and catheter-based anticoagulation.
Anticoagulant drugs
Intracranial hemorrhage (ICH), defined as any primary cranial cavity hemorrhage clinically evident and confirmed by brain imaging or autopsysafety
A newly developed predictive model incorporating six clinical and laboratory factors can effectively identify patients at high risk for intracranial hemorrhage during anticoagulant therapy.
Effect estimate: AUC 0.883 (95% CI 0.847-0.918)
p-value: p=<0.001
Objectives: The use of anticoagulants in patients increases the risk of intracranial hemorrhage (ICH). Our aim was to identify factors associated with cerebral hemorrhage in patients using anticoagulants and to develop a predictive model that would provide an effective tool for the clinical assessment of cerebral hemorrhage. Methods: In our study, indications for patients receiving anticoagulation included AF, VTE, stroke/TIA, arteriosclerosis, peripheral vascular diseases (PVD), prosthetic mechanical valve replacement, etc. Data were obtained from the patient record hospitalization system. Logistic regression, area under the curve (AUC), and bar graphs were used to build predictive models in the development cohort. The models were internally validated, analytically characterized, and calibrated using AUC, calibration curves, and the Hosmer-Lemeshow test. Results: -blockers were protective factors. The model was constructed using these six factors with an AUC value of 0.883. In the validation cohort, the model had good discriminatory power (AUC = 0.801) and calibration power. Five-fold cross-validation showed Kappa of 0.483. Conclusion: Predictive models based on a patient's medical record hospitalization system can be used to identify patients at risk for cerebral hemorrhage. Identifying people at risk can provide proactive interventions for patients.
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Fuxin Ma
Fujian Medical University
Zhiwei Zeng
Fujian Medical University
Jiana Chen
Fujian Medical University
Frontiers in Neurology
Fujian Medical University
Union Hospital
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Ma et al. (Wed,) conducted a cohort in Patients using anticoagulant drugs (n=617). Alfalfa-Anticoagulant-ICH score vs. HAS-BLED score was evaluated on Prediction of intracranial hemorrhage (AUC in development cohort) (AUC 0.883, 95% CI 0.847-0.918, p=<0.001). The Alfalfa-Anticoagulant-ICH score, incorporating six clinical factors including leukoaraiosis and fall risk, accurately predicted intracranial hemorrhage in patients using anticoagulants with an AUC of 0.883.
synapsesocial.com/papers/6a0ed40425c30b2cc7f9d012 — DOI: https://doi.org/10.3389/fneur.2025.1475956