HAS-BLED visar blödningsrisk vid ischemisk stroke och förmaksflimmer. Men justeringar behövs för säkrare bedömning, enligt kvalitetsstudie
Engelsk titel: HAS-BLED shows bleeding risk in ischemic stroke and atrial fibrillation. But adjustments are needed for safer assessment, according to quality study
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Författare:
Alshakarchi, Jinan
;
Terent, Andreas
Email: jinan.al-shakarchi@akademiska.se
Språk: Swe
Antal referenser: 8
Dokumenttyp:
Artikel
UI-nummer: 12107431
Sammanfattning
It is difficult to estimate the risk and benefit ratio of anticoagulant therapy in patients with ischemic stroke and atrial fibrillation. The scoring system HAS-BLED is considered a simple tool for estimation of bleeding risk, and another scoring system, CHA2DS2-VASc, is recommended for estimation of the risk for trombo-embolism. Our study shows that almost two thirds of ischemic stroke patients with atrial fibrillation have 2 scoring points according to HAS-BLED, i.e. moderately increased bleeding risk. However the risk for trombo-embolism is high among most of these patients according to the CHA2DS2-VASc score, and anticoagulant therapy may therefore be considered. One third approximately of the patients have 3 scoring points or more according to HAS-BLED, which implies increased bleeding risk. Caution with warfarin therapy is recommended in these patients. There is considerable overlap between the bleeding score HAS-BLED and the risk score for trombo-embolism CHA2DS2-VASc. There is a need to develop and improve HAS-BLED with respect to age, previous stroke and renal function.