cliot (version 1.0.0)

hemorr2hages_score: HEMORR2HAGES Score for Major Bleeding Risk

Description

Calculates the HEMORR2HAGES score to estimate the risk of major bleeding in elderly patients with atrial fibrillation who are taking warfarin. This score is considered more sensitive than CHADS2 for identifying bleeding risk in this specific population.

Usage

hemorr2hages_score(hepatic_renal_disease, ethanol_abuse, malignancy, age_gt_75,
                   reduced_platelets_function, prior_bleed, hypertension, anemia,
                   genetic_factors, fall_risk, stroke_history)

Value

A list containing:

HEMORR2HAGES_Score

The calculated score (Range 0-12).

Risk_Category

Classification (Low, Intermediate, High).

Bleeding_Risk_per_100_Pt_Years

Estimated number of major bleeds per 100 patient-years.

Arguments

hepatic_renal_disease

Numeric (0 or 1). Hepatic or Renal Disease. (1 = Yes, +1 point).

ethanol_abuse

Numeric (0 or 1). Ethanol (Alcohol) Abuse. (1 = Yes, +1 point).

malignancy

Numeric (0 or 1). History of Malignancy. (1 = Yes, +1 point).

age_gt_75

Numeric (0 or 1). Age > 75 years. (1 = Yes, +1 point).

reduced_platelets_function

Numeric (0 or 1). Reduced platelet count or function (e.g., Aspirin use). (1 = Yes, +1 point).

prior_bleed

Numeric (0 or 1). History of prior bleeding (Re-bleeding risk). (1 = Yes, +2 points).

hypertension

Numeric (0 or 1). Uncontrolled Hypertension. (1 = Yes, +1 point).

anemia

Numeric (0 or 1). Anemia. (1 = Yes, +1 point).

genetic_factors

Numeric (0 or 1). Genetic factors (e.g., CYP2C9 polymorphisms). (1 = Yes, +1 point).

fall_risk

Numeric (0 or 1). Excessive Fall Risk. (1 = Yes, +1 point).

stroke_history

Numeric (0 or 1). History of Stroke. (1 = Yes, +1 point).

References

Gage BF, Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719. doi:10.1016/j.ahj.2005.04.017

Examples

# Example 1: High Risk
# Prior Bleed (+2), Age >75 (+1), HTN (+1)
# Score = 4
hemorr2hages_score(0, 0, 0, 1, 0, 1, 1, 0, 0, 0, 0)

# Example 2: Low Risk
# No risk factors
# Score = 0
hemorr2hages_score(0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0)