Validación de Escalas Hasbled vs Atria para el pronóstico de eventos hemorrágicos en pacientes de 55-85 años con fibrilación auricular con terapia anticoagulante del Hospital de Especialidades Teodoro Maldonado Carbo en el periodo 2017-2018.

Abstract

Background: Atrial fibrillation is one of the causes of thromboembolism and sudden death in the world, making anticoagulant treatment a cornerstone, however, it is associated with bleeding risk. Due to this phenomenon, the HASBLED prognostic scale is created, becoming the main one recommended by the guidelines; nonetheless because of its limitation in measuring INR, a new prediction model is published: ATRIA. Objective: To validate the scales HASBLED vs ATRIA for the prognosis of bleeding events in patients aged 55-85 years with atrial fibrillation with anticoagulant therapy. Materials and methods: The study was observational, retrospective, transversal and analytuc; using the electronic medical records of the AS400 system of the Hospital of Specialties Teodoro Maldonado Carbo. The initial search yielded a population of 4885 patients, of which it was reduced to a sample of 100. Results: The HASBLED scale is better than ATRIA (p=0.000). So, a patient who had a score of “2” HASBLED, belongs to a score “0” ATRIA. The anticoagulant drug that caused the most bleeding events was warfarin 59%. Regarding the type of bleeding, lower digestive hemorrhages were the ones considered in the highest proportion (38%). There is no predominance between the male and female sex, regarding bleeding risk to the HASBLED (p= 0.082) and ATRIA (p=0.056) scales. Conclusion: The HASBLED scale is the leading tool to calculate the probability of bleeding in patients with atrial fibrillation with anticoagulant treatment.