Practical-Manual-Scores-Algorithms-Haemostasis-Thrombosis

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Atrial FibrillationCHA 2DS 2-VASc risk scoreRisk factorScoreCongestive heart failure 1Hypertension 1Age ≥ 75 years 2Diabetes 1Prior Stroke or TIA or Thromboembolism 2Vascular disease(peripheral artery disease, myocardial infarction, aortic plaque)1Age between 65 and 74 years 1Sex category (i.e. female gender) 1Maximum score 9InterpretationLow risk = 0 (males) or 1 (females)Moderate risk = 1 (males)High risk ≥ 2The ESC guidelines de-emphasises the ‘traditional’ (but artificial) low,moderate and high risk stratification and recommends a risk factor-basedapproach using the ‘CHA 2DS 2-VASc’ score.The initial focus is now on identification of ‘truly low-risk’ patients with AF,that is, those ‘age < 65 and lone AF (irrespective of gender)’ – which isessentially a CHA 2DS 2-VASc score = 0 (males) or 1 (females). Such ‘lowrisk’ patients do not need any antithrombotic therapy.After this initial decision step, patients with AF and ≥ 1 stroke risk factors canbe offered effective stroke prevention, which is oral anticoagulation (OAC).The latter can be delivered either as well controlled VKA (as reflected byaverage Time in Therapeutic Range [TTR] ≥ 70%) or one of the NOACs.26
References• Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelinesfor the management of atrial fibrillation: An update of the 2010 ESC Guidelines forthe management of atrial fibrillation. Eur Heart J. 2012;33:2719-47.• De Caterina R, Husted S, Wallentin L, et al. Vitamin K antagonists in heartdisease: Current status and perspectives (section III). Position paper of the escworking group on thrombosis - task force on anticoagulants in heart disease.Thromb Haemost. 2013;110:1087-107.• Lip GY. Stroke and bleeding risk assessment in atrial fibrillation: When, how, andwhy? Eur Heart J. 2013;34:1041-9.• Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predictingstroke and thromboembolism in atrial fibrillation using a novel risk factor-basedapproach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263-72.• Pisters R, Lane DA, Marin F, et al. Stroke and thromboembolism in atrial fibrillation.Circ J. 2012;76:2289-304.Atrial Fibrillation27
Page 1 and 2: Practical manualScores and Algorith
Page 3: Scientific boardHenri BounameauxDiv
Page 6 and 7: SummaryBleedingISTH bleeding assess
Page 9 and 10: Clinical probability model for deep
Page 11 and 12: FeatureGeneva scoresPoints(revised
Page 13 and 14: InterpretationClinical decision rul
Page 15 and 16: 6 features with a similar validity.
Page 17 and 18: Prediction of recurrent deep vein T
Page 19 and 20: Outpatient versus inpatient care in
Page 21 and 22: Assessment of post-thrombotic syndr
Page 23 and 24: Diagnostic algorithm in suspected p
Page 25: Prediction of stroke risk in patien
Page 29 and 30: References• Friberg L, Rosenqvist
Page 31 and 32: InterpretationThis score identifies
Page 33 and 34: Vienna score (Ay Model): DVT or PE
Page 35 and 36: Risk assessment modelsin hospitaliz
Page 37 and 38: References• Chopard P, Spirk D, B
Page 39 and 40: Recommendations for the determinati
Page 41 and 42: Template for scoring system for non
Page 43 and 44: Diagnosis of Thrombotic Thrombocyto
Page 45 and 46: Management of patientswith occlusio
Page 47 and 48: Symptoms(up to the time of diagnosi
Page 49 and 50: InterpretationA bleeding score > 3
Page 51 and 52: Pediatric Bleeding scoreSymptoms Sc
Page 53 and 54: Bleeding assessment tool for the ev
Page 55 and 56: The SMOG system (cont.)Type of blee
Page 57 and 58: The SMOG system (cont.)Type of blee
Page 59 and 60: Diagnostic and therapeutic algorith
Page 61 and 62: Bridging strategies in patients on
Page 64: Practical manualof scores and algor

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