The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
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Tarih
2023
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info:eu-repo/semantics/closedAccess
Özet
Background: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS)
is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major
bleeding in ACS patients are limited.
Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major
bleeding risk in patients with ACS.
Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver
operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The
predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI).
Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31
patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were
BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02–5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54
(0.45–0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01–1.06), p = 0.039] were independent
predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61–3.95), p < 0.001] and risk categories [OR (95 %
CI), 3.06 (1.69–5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant
difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p =
0.026) and an IDI of 4.2 % (p < 0.001).
Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
Açıklama
Anahtar Kelimeler
Acute coronary syndrome Major bleeding Risk assessment Antithrombotic therapy Anticoagulant therapy
Kaynak
THROMBOSIS RESEARCH
WoS Q Değeri
Q1
Scopus Q Değeri
Cilt
229