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In patients with atrial fibrillation (AF), the decision to prescribe warfarin depends on risks for both stroke and bleeding. In this analysis of 9186 AF patients who were receiving warfarin, researchers derived and validated five factors that predicted risk for major bleeding: anemia (3 points), severe renal disease (3 points), age ≥75 (2 points), and prior bleeding and hypertension (1 point each).
Risk for major hemorrhage was approximately 1.4% annually; it ranged from 0.4% for patients with 0 points to 17.3% for those with 10 points. Patients with scores of 0–3 were considered to have low risk (0.8% annually), those with a score of 4 had intermediate risk (2.6%), and those with scores of 5–10 had high risk (5.8%) in a split validation coh…