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Is the ORBIT bleeding risk score superior to the HAS-BLED score in anticoagulated atrial fibrillation patients?
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Background: several bleeding risk scores have been validated in patients with atrial fibrillation (AF). The ORBIT score has been recently proposed as a simple score with the best ability to predict major bleeding. The present study aimed to test the hypothesis that the ORBIT score was superior to the HAS-BLED score for predicting major bleeding and death in "real world" anticoagulated AF patients. Methods and results: we analyzed the predictive performance for bleeding and death of 406 AF patients who underwent 571 electrical cardioversion procedures and 1,276 patients with permanent/persistent AF from the FANTASIIA registry. In the cardioversion population, 21 patients had major bleeding events and 26 patients died. The predictive performance for major bleeding of HAS-BLED and ORBIT were not significantly different (c-statistics 0.77 (95% CI 0.66-0.88) and 0.82 (95% CI 0.77-0.93), respectively; P=0.080). For the FANTASIIA population, 46 patients had major bleeding events and 50 patients died. The predictive performances for major bleeding of HASBLED and ORBIT were not significantly different (c-statistics 0.63 (95% CI 0.56-0.71) and 0.70 (95% CI 0.62-0.77), respectively; P=0.116). For death, the predictive performances of HAS-BLED and ORBIT were not significantly different in both populations. The ORBIT score categorized most patients as "low risk". Conclusions: despite the original claims in its derivation paper, the ORBIT score was not superior to HAS-BLED for predicting major bleeding and death in a "real world" oral anticoagulated AF population. (Circ J 2016; 80:2102 - 2108)
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ESTEVE-PASTOR, María asunción, GARCÍA-FERNÁNDEZ, Amaya, MACÍAS, Manuel, SOGORB, Francisco, VALDÉS, Mariano, ROLDÁN, Vanesa, MUÑIZ, Javier, BADIMÓN, Lina, ROLDÁN, Inmaculada, BERTOMEU MARTÍNEZ, Vicente, CEQUIER FILLAT, Àngel r., LIP, Gregory y.h., ANGUITA, Manuel, MARÍN, Francisco. Is the ORBIT bleeding risk score superior to the HAS-BLED score in anticoagulated atrial fibrillation patients?. _Circulation Journal_. 2016. Vol. 80, núm. 10, pàgs. 2102-2108. [consulta: 23 de gener de 2026]. ISSN: 1346-9843. [Disponible a: https://hdl.handle.net/2445/133597]