cliot (version 1.0.0)

doac_bleeding_risk: DOAC Score for Bleeding Risk

Description

Calculates the DOAC Score to estimate the risk of major bleeding in patients with atrial fibrillation taking Direct Oral Anticoagulants (DOACs). This score was derived specifically for DOAC users, distinguishing it from HAS-BLED which was derived for Warfarin.

Usage

doac_bleeding_risk(age, criteria_count_gt_1, creatinine_clearance_ml_min,
                   prior_bleeding, hypertension, nsaids_antiplatelets,
                   cirrhosis_history, history_stroke, prior_major_bleeding,
                   extreme_body_weight)

Value

A list containing:

DOAC_Score

The calculated risk score.

Risk_Category

Classification (Low <=3, Moderate 4-7, High >=8).

Arguments

age

Numeric. Patient age in years. (65-74: +1 pt; >=75: +2 pts).

criteria_count_gt_1

Numeric (0 or 1). Does the patient meet criteria for having >1 comorbid condition (e.g., diabetes, stroke, etc.)? (1 = Yes, +2 pts). (Note: This input simplifies a complex comorbidity count often used in the original derivation).

creatinine_clearance_ml_min

Numeric. Creatinine Clearance (CrCl). (< 60 mL/min adds +1 pt).

prior_bleeding

Numeric (0 or 1). History of any prior bleeding event (minor or major). (1 = Yes, +2 pts).

hypertension

Numeric (0 or 1). History of Hypertension. (1 = Yes, +1 pt).

nsaids_antiplatelets

Numeric (0 or 1). Concomitant use of NSAIDs or Antiplatelets. (1 = Yes, +1 pt).

cirrhosis_history

Numeric (0 or 1). History of Liver Cirrhosis. (1 = Yes, +1 pt).

history_stroke

Numeric (0 or 1). History of Stroke/TIA. (1 = Yes, +1 pt).

prior_major_bleeding

Numeric (0 or 1). History of Major Bleeding specifically. (1 = Yes, +1 pt).

extreme_body_weight

Numeric (0 or 1). Extreme body weight (<50kg or >100kg). (1 = Yes, +1 pt).

References

Kozieł-Siołkowska M, et al. A Novel Bleeding Risk Score for Patients with Atrial Fibrillation on Direct Oral Anticoagulants (The DOAC Score). Cardiology. 2018.

Examples

# Example 1: Moderate Risk
# Age 70 (+1), CrCl 50 (+1), HTN (+1), NSAIDs (+1)
# Score = 4
doac_bleeding_risk(70, 0, 50, 0, 1, 1, 0, 0, 0, 0)

# Example 2: High Risk
# Age 80 (+2), Prior Bleed (+2), Major Bleed (+1), Stroke (+1), Wt<50 (+1), CrCl 40 (+1)
# Score = 8
doac_bleeding_risk(80, 0, 40, 1, 0, 0, 0, 1, 1, 1)