The Cardiovascular
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DOAC Score for Bleeding Risk in Atrial Fibrillation

Major bleeding risk in AF patients on a direct oral anticoagulant.

DOAC Score for Bleeding Risk in Atrial Fibrillation
Age
years
Creatinine clearance / eGFR
mL/min
Underweight (BMI <18.5 kg/m2)
Prior stroke / TIA / systemic embolism
Diabetes mellitus
Hypertension
Regular NSAID use
Liver disease
Prior major bleeding
Antiplatelet therapy
Complete the fields above to see the result.

When to use

  • Estimating bleeding risk specifically in AF patients treated with a DOAC.

Formula

Age (65-69:2, 70-74:3, 75-79:4, >=80:5); CrCl 30-60:1, <30:2; underweight 1; stroke/TIA/embolism 1; diabetes 1; hypertension 1; NSAID 1; liver disease 2; prior bleeding 3; aspirin 2 or DAPT 3.

Pearls and pitfalls

  • Outperformed HAS-BLED for DOAC-treated AF in the derivation cohorts.
  • Bleeding rates are approximate and cohort-dependent.

References

  1. Aggarwal R, et al. Circulation. 2023;148(12):936-946.