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Title:	Is the ORBIT bleeding risk score superior to the HAS-BLED score in anticoagulated atrial fibrillation patients?
Author:	Esteve-Pastor, María Asunción; García-Fernández, Amaya; Macías, Manuel; Sogorb, Francisco; Valdés, Mariano; Roldán, Vanesa; Muñiz, Javier; Badimón, Lina, 1953-; Roldán, Inmaculada; Bertomeu-Martínez, Vicente; Cequier Fillat, Àngel R.; Lip, Gregory Y.H.; Anguita, Manuel; Marín, Francisco
Other authors:	Universitat de Barcelona
Abstract:	Background: several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding and death in "real world" anticoagulated AF patients. Methods and results: we analyzed the predictive performance for bleeding and death of 406 AF patients who underwent 571 electrical cardioversion procedures and 1,276 patients with permanent/persistent AF from the FANTASIIA registry. In the cardioversion population, 21 patients had major bleeding events and 26 patients died. The predictive performance for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.77 (95% CI 0.66-0.88) and 0.82 (95% CI 0.77-0.93), respectively; P=0.080). For the FANTASIIA population, 46 patients had major bleeding events and 50 patients died. The predictive performances for major bleeding of HASBLED and ORBIT were not significantly different (c-statistics 0.63 (95% CI 0.56-0.71) and 0.70 (95% CI 0.62-0.77), respectively; P=0.116). For death, the predictive performances of HAS-BLED and ORBIT were not significantly different in both populations. The ORBIT score categorized most patients as "low risk". Conclusions: despite the original claims in its derivation paper, the ORBIT score was not superior to HAS-BLED for predicting major bleeding and death in a "real world" oral anticoagulated AF population. (Circ J 2016; 80:2102 - 2108)
Subject(s):	-Fibril·lació auricular -Paravents -Efectes secundaris dels medicaments -Hemorràgia -Coagulació -Atrial fibrillation -Screens -Drug side effects -Hemorrhage -Coagulation
Rights:	(c) Japanese Circulation Society, 2016
Document type:	Article Article - Published version
Published by:	Japanese Circulation Society
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