The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome

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dc.authorid0000-0001-6985-6112en_US
dc.contributor.authorGünlü, Serhat
dc.contributor.authorArpa, Abdulkadir
dc.contributor.authorKayan, Fethullah
dc.contributor.authorGüzel, Tuncay
dc.contributor.authorKılıç, Raif
dc.contributor.authorAktan, Adem
dc.contributor.authorBernas, Altıntaş
dc.contributor.authorKarahan, Mehmet Zülkif
dc.date.accessioned2023-12-11T11:39:06Z
dc.date.available2023-12-11T11:39:06Z
dc.date.issued2023en_US
dc.departmentMAÜ, Fakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalıen_US
dc.description.abstractBackground: 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.en_US
dc.identifier.doi10.1016/j.thromres.2023.05.007en_US
dc.identifier.endpage262en_US
dc.identifier.issn0049-3848
dc.identifier.startpage258en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12514/4534
dc.identifier.volume229en_US
dc.identifier.wosWOS:001071164700001en_US
dc.identifier.wosqualityQ1en_US
dc.institutionauthorGünlü, Serhat
dc.language.isoenen_US
dc.publisherELSEVIERen_US
dc.relation.ispartofTHROMBOSIS RESEARCHen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute coronary syndrome Major bleeding Risk assessment Antithrombotic therapy Anticoagulant therapyen_US
dc.titleThe prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndromeen_US
dc.typeArticleen_US

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