Exam

Direct Oral Anticoagulant Score

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Direct Oral Anticoagulant Score, DOAC Score

  • See Also
  1. HAS-BLED Score
  2. Outpatient Bleeding Risk Index
  3. Atrial Fibrillation Anticoagulation
  4. CHADS2-VASc Score
  5. Orbit Bleeding Risk Score
  6. Direct Oral Anticoagulant
  • Indications
  1. Bleeding Risk in Atrial Fibrillation Patients on DOACs
    1. DOAC Score was specifically developed to predict the bleeding risk on DOACs
    2. Contrast with the HAS-BLED Score, developed to assess bleeding risk with Warfarin
  • Criteria
  1. Age (select one or none)
    1. Score 2: Age 65 to 69 years
    2. Score 3: Age 70 to 74 years
    3. Score 4: Age 75 to 79 years
    4. Score 5: Age 80 years or older
  2. Creatinine Clearance (eGFR, select one or none)
    1. Score 1: eGFR 30 to 60 ml/min
    2. Score 2: eGFR <30 ml/min
  3. Underweight (select one or none)
    1. Score 1: BMI <18.5 kg/m2
  4. Antiplatelet Use (select one or none)
    1. Score 2: Aspirin
    2. Score 3: Dual Antiplatelet Agents
  5. History (select any that apply)
    1. Score 1: Stroke, TIA or systemic embolism history
    2. Score 1: Diabetes Mellitus
    3. Score 1: Hypertension
    4. Score 1: NSAID Use
    5. Score 3: Bleeding History
    6. Score 2: Liver Disease
  • Interpretation
  1. Total score tallied from criteria: 0 to 10 (max 10)
  2. Bleeding Risk based on total score
    1. Score 0 to 3: Very Low Bleeding Risk
      1. Major Bleeding Risk at 1 year: 0.8%
      2. Life-Threatening Bleeding Risk at 1 year: 0.3%
    2. Score 4 to 5: Low Bleeding Risk
      1. Major Bleeding Risk at 1 year: 1.6%
      2. Life-Threatening Bleeding Risk at 1 year: 0.6%
    3. Score 6 to 7: Moderate Bleeding Risk
      1. Major Bleeding Risk at 1 year: 3.4%
      2. Life-Threatening Bleeding Risk at 1 year: 1.4%
    4. Score 8 to 9: High Bleeding Risk
      1. Major Bleeding Risk at 1 year: 6.9%
      2. Life-Threatening Bleeding Risk at 1 year: 2.9%
    5. Score 10: Very High Bleeding Risk
      1. Major Bleeding Risk at 1 year: 13.9%
      2. Life-Threatening Bleeding Risk at 1 year: 6.3%
  • References
  1. Aggarwal (2023) Circulation 148(12): 936-46 [PubMed]