Outpatient Bleeding Risk Index OBRI
The Outpatient Bleeding Risk Index is used to help predict the risk of bleeding with anticoagulation. An approach to the decision of warfarin for oral anticoagulation for atrial fibrillation is suggested in [link url="http://www.aafp.org/afp/2005/0615/afp20050615p2348-f1.pdf" memo="(link)"] Am Fam Physician. 2005 Jun 15;71(12):2348-2350. 1) Use the [link url="../../cardiovascular/chads2/" memo="(link)"] CHADS2 rule as well as the [link url="../../cardiovascular/accp-stroke-risk-calculator/" memo="(link)"] ACCP rule to determine the risk of stroke. 2) If both these measures predict moderate risk of stroke, proceed to calculate the [link url="../../cardiovascular/outpatient-bleeding-risk-index-obri/" memo="(link)"] Outpatient Bleeding Risk Index and weigh the risks versus the benefits. [select name="Q1" value="No (0 points)=0|YES (1 point)=1"] <-- Age 65 or older [select name="Q2" value="No (0 points)=0|YES (1 point)=1"] <-- History of GI tract bleeding [select name="Q3" value="No (0 points)=0|YES (1 point)=1"] <-- History of stroke [select name="Q4" value="No (0 points)=0|YES (1 point)=1"] <-- Recent MI, hematocrit lower than 30 percent, creatinine higher than 1.5, or diabetes mellitus. Score --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)" memo="score"] out of 4 points Interpretation (percent of cases with major bleeding at 1 year) --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4);score>2?'High risk(10.6-48%)':score>0?'Intermediate risk (2.5-12%)':'Low risk (0-3%)'" memo="interpretation"] [checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"] references: [link url="//www.aafp.org/afp/2005/0615/p2348.html" memo="#1"] Am Fam Physician. 2005 Jun 15;71(12):2348-2350. [link url="//www.aafp.org/afp/2010/0315/p780.html" memo="#2"] Am Fam Physician. 2010 Mar 15;81(6):780-782.[/conditional]
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