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ORBIT Bleeding Risk Score for Atrial Fibrillation
Estimates major bleeding risk on anticoagulation for atrial fibrillation.
ORBIT Bleeding Risk Score for Atrial Fibrillation
Age >= 74 years
Reduced haemoglobin/haematocrit or history of anaemia (Hb <12 g/dL or Hct <36% in women; Hb <13 g/dL or Hct <40% in men)
History of major bleeding (gastrointestinal or intracranial)
eGFR < 60 mL/min/1.73 m^2
Concurrent antiplatelet therapy
Result0 points
Approximately 2.4 major bleeding events per 100 patient-years in the derivation cohort.
- Bleeding rate
- 2.4 per 100 patient-years
When to use
- Estimating bleeding risk when weighing anticoagulation for atrial fibrillation, alongside a thromboembolic risk score such as CHA2DS2-VASc.
Formula
Sum of: age >=74y (1), reduced haemoglobin/haematocrit or anaemia history (2), prior major bleeding (2), eGFR <60 mL/min/1.73m^2 (1), concurrent antiplatelet use (1). Range 0-7.
Pearls and pitfalls
- Included in the 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline as an option for bleeding risk assessment.
- Performed at least as well as HAS-BLED and ATRIA in external comparisons, including in patients on direct oral anticoagulants.