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Clinical prediction guide
The Outpatient Bleeding Risk Index predicted major bleeding in patients taking warfarin

http://dx.doi.org/10.1136/ebm.11.4.120

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    Aspinall SL, DeSanzo BE, Trilli LE, et al. Bleeding Risk Index in an anticoagulation clinic. Assessment by indication and implications for care. J Gen Intern Med 2005;20:1008–13.
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 Q In patients taking warfarin, how accurate is the Outpatient Bleeding Risk Index for predicting major bleeding?

    Clinical impact ratings Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆ Haematology ★★★★★★☆ Neurology ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    retrospective cohort study to validate the previously developed Outpatient Bleeding Risk Index in a veteran population.

    Embedded ImageSetting:

    a pharmacist run anticoagulation clinic at the Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.

    Embedded ImagePatients:

    1269 patients (mean age 68 y, 92% men, 82% white) taking warfarin for <1 to >36 months.

    Embedded ImageDescription of prediction guide:

    the Outpatient Bleeding Risk Index (range 0–4) is a summation of 4 factors: (i) age (⩾65 y  =  1), (ii) history of stroke  =  1, (iii) history of gastrointestinal bleeding  =  1, and (iv) presence of ⩾1 serious comorbidity (recent myocardial …

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    Footnotes

    • For correspondence: Dr S L Aspinall, VA Pittsburgh Healthcare System, PA, USA. sherrie.aspinall{at}med.va.gov

    • Source of funding: no external funding.