PMID- 26395301
OWN - NLM
STAT- MEDLINE
DCOM- 20170119
LR  - 20170119
IS  - 2115-7863 (Electronic)
IS  - 2115-7863 (Linking)
VI  - 13
IP  - 3
DP  - 2015 Sep
TI  - [Comparison of the HAS-BLED and ATRIA scores for the risk of bleeding in patients 
      aged 75 and over receiving vitamin K antagonist (VKA) therapy and educated 
      VKA-management].
PG  - 279-88
LID - 10.1684/pnv.2015.0562 [doi]
AB  - Bleeding is the main complication on vitamin K antagonist treatment (VKA), 
      particularly in elderly patients. However, the bleeding risk prediction in 
      geriatric patients remains difficult. We evaluated the predictive value of the 
      HAS-BLED and ATRIA bleeding scores in VKA-treated patients aged 75 and over. 
      Various clinical bleeding risk factors in elderly were also studied. 208 patients 
      were included in a case-control study: 52 hemorrhages cases were compared to 156 
      hemorrhage-free cases (controls), mean age 83.1 years in cases and 82.6 in 
      controls. This elderly subgroup was provided from the prospective SCORE cohort 
      study (study designed to validate the use of bleeding scores in an ambulatory 
      population). The patients were included during a VKA-therapeutic education 
      between May 2009 and May 2010 in 4 French hospitals, and followed for 1 year. The 
      primary endpoint, collected prospectively, was the occurrence of severe and 
      clinically relevant bleeding events. According to the Receiver operating 
      characteristics (ROC), the ATRIA score was as effective as HAS- BLED to predict 
      all bleeding (c-statistic: 0.59 [95% CI 0.50-0.68] vs 0.56 [0.48-0.65]) including 
      severe bleeding (c-statistic: 0.64 [95% CI 0.49-0.79] vs 0.62 [0.49-0.75]). 
      Multivariate Cox regression analysis showed increasing bleeding risk with anemia 
      (OR = 2.6 [95% CI 1.34-5.23], p = 0.005), serotonin reuptake inhibitors (2.8 
      [1.08-7.47], 0.034), and family-management of VKA-treatment (2.8 [1.28-6.15], 
      0.01). ATRIA hemorrhage predictive value can be improved by adding such 
      parameters as family-management of VKA-treatment and serotonin reuptake 
      inhibitors treatment. ATRIA appears as relevant as HAS-BLED in predicting all 
      bleeding including major hemorrhages in elderly patients educated VKA-management. 
      The ATRIA bleeding score is improved by including items of serotonin reuptake 
      inhibitors treatment and family-management of VKA-treatment.
FAU - Soave, Claire
AU  - Soave C
AD  - Departement de medecine generale, Universite Grenoble Alpes, France.
FAU - Chidlovskii, Elena
AU  - Chidlovskii E
AD  - Clinique universitaire de medecine geriatrique, CHU de Grenoble, France.
FAU - Lebelhomme, Audrey
AU  - Lebelhomme A
AD  - Departement de medecine generale, Universite Grenoble Alpes, France.
FAU - Gaboreau, Yoann
AU  - Gaboreau Y
AD  - Departement de medecine generale, Universite Grenoble Alpes, France, CNRS 
      TIMC-IMAG, Universite Grenoble Alpes, France.
FAU - Pernod, Gilles
AU  - Pernod G
AD  - CNRS TIMC-IMAG, Universite Grenoble Alpes, France, Clinique universitaire de 
      medecine vasculaire, CHU de Grenoble, France.
FAU - Bosson, Jean Luc
AU  - Bosson JL
AD  - CNRS TIMC-IMAG, Universite Grenoble Alpes, France, Inserm CIC 1406, CHU de 
      Grenoble, France.
FAU - Couturier, Pascal
AU  - Couturier P
AD  - Clinique universitaire de medecine geriatrique, CHU de Grenoble, France, CNRS 
      TIMC-IMAG, Universite Grenoble Alpes, France.
LA  - fre
PT  - Comparative Study
PT  - Journal Article
TT  - Comparaison de l'efficacite des scores HAS-BLED et ATRIA dans la prediction du 
      risque hemorragique des patients de plus de 75 ans traites par anti-vitamine K 
      (AVK) apres demarche d'education therapeutique.
PL  - France
TA  - Geriatr Psychol Neuropsychiatr Vieil
JT  - Geriatrie et psychologie neuropsychiatrie du vieillissement
JID - 101553404
RN  - 0 (Anticoagulants)
RN  - 12001-79-5 (Vitamin K)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*adverse effects
MH  - Cohort Studies
MH  - Female
MH  - Geriatric Assessment
MH  - Hemorrhage/*chemically induced/diagnosis/*epidemiology
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Vitamin K/*antagonists & inhibitors
OTO - NOTNLM
OT  - ATRIA
OT  - HAS-BLED
OT  - bleeding
OT  - elderly
OT  - vitamin K antagonist
EDAT- 2015/09/24 06:00
MHDA- 2017/01/20 06:00
CRDT- 2015/09/24 06:00
PHST- 2015/09/24 06:00 [entrez]
PHST- 2015/09/24 06:00 [pubmed]
PHST- 2017/01/20 06:00 [medline]
AID - pnv.2015.0562 [pii]
AID - 10.1684/pnv.2015.0562 [doi]
PST - ppublish
SO  - Geriatr Psychol Neuropsychiatr Vieil. 2015 Sep;13(3):279-88. doi: 
      10.1684/pnv.2015.0562.