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Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score

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Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score. / Biancari, Fausto; Brascia, Debora; Onorati, Francesco; Reichart, Daniel; Perrotti, Andrea; Ruggieri, Vito G; Santarpino, Giuseppe; Maselli, Daniele; Mariscalco, Giovanni; Gherli, Riccardo; Rubino, Antonino S; De Feo, Marisa; Gatti, Giuseppe; Santini, Francesco; Dalén, Magnus; Saccocci, Matteo; Kinnunen, Eeva-Maija; Airaksinen, Juhani K E; D'Errigo, Paola; Rosato, Stefano; Nicolini, Francesco.

in: THROMB HAEMOSTASIS, Jahrgang 117, Nr. 3, 28.02.2017, S. 445-456.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Biancari, F, Brascia, D, Onorati, F, Reichart, D, Perrotti, A, Ruggieri, VG, Santarpino, G, Maselli, D, Mariscalco, G, Gherli, R, Rubino, AS, De Feo, M, Gatti, G, Santini, F, Dalén, M, Saccocci, M, Kinnunen, E-M, Airaksinen, JKE, D'Errigo, P, Rosato, S & Nicolini, F 2017, 'Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score', THROMB HAEMOSTASIS, Jg. 117, Nr. 3, S. 445-456. https://doi.org/10.1160/TH16-09-0721

APA

Biancari, F., Brascia, D., Onorati, F., Reichart, D., Perrotti, A., Ruggieri, V. G., Santarpino, G., Maselli, D., Mariscalco, G., Gherli, R., Rubino, A. S., De Feo, M., Gatti, G., Santini, F., Dalén, M., Saccocci, M., Kinnunen, E-M., Airaksinen, J. K. E., D'Errigo, P., ... Nicolini, F. (2017). Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score. THROMB HAEMOSTASIS, 117(3), 445-456. https://doi.org/10.1160/TH16-09-0721

Vancouver

Biancari F, Brascia D, Onorati F, Reichart D, Perrotti A, Ruggieri VG et al. Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score. THROMB HAEMOSTASIS. 2017 Feb 28;117(3):445-456. https://doi.org/10.1160/TH16-09-0721

Bibtex

@article{1bef309182d34a769e61ff9e4cca0b1b,
title = "Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score",
abstract = "Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m2 (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding. The WILL-BLEED score was associated with increasing rates of severe bleeding in both the derivation and validation cohorts (scores 0-3: 2.9 % vs 3.4 %; scores 4-6: 6.8 % vs 7.5 %; scores>6: 24.6 % vs 24.2 %, both p<0.0001). The WILL-BLEED score had a better discriminatory ability (AUC 0.725) for prediction of severe bleeding compared to the ACTION (AUC 0.671), CRUSADE (AUC 0.642), Papworth (AUC 0.605), TRUST (AUC 0.660) and TRACK (AUC 0.640) bleeding scores. The net reclassification index and integrated discrimination improvement using the WILL-BLEED score as opposed to the other bleeding scores were significant (p<0.0001). The decision curve analysis demonstrated a net benefit with the WILL-BLEED score compared to the other bleeding scores. In conclusion, the WILL-BLEED risk score is a simple risk stratification method which allows the identification of patients at high risk of severe bleeding after CABG.",
keywords = "Aged, Area Under Curve, Clinical Decision-Making, Coronary Artery Bypass/adverse effects, Coronary Artery Disease/blood, Decision Support Techniques, Europe, Female, Humans, Male, Middle Aged, Postoperative Hemorrhage/etiology, Predictive Value of Tests, Prospective Studies, ROC Curve, Registries, Reproducibility of Results, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome",
author = "Fausto Biancari and Debora Brascia and Francesco Onorati and Daniel Reichart and Andrea Perrotti and Ruggieri, {Vito G} and Giuseppe Santarpino and Daniele Maselli and Giovanni Mariscalco and Riccardo Gherli and Rubino, {Antonino S} and {De Feo}, Marisa and Giuseppe Gatti and Francesco Santini and Magnus Dal{\'e}n and Matteo Saccocci and Eeva-Maija Kinnunen and Airaksinen, {Juhani K E} and Paola D'Errigo and Stefano Rosato and Francesco Nicolini",
year = "2017",
month = feb,
day = "28",
doi = "10.1160/TH16-09-0721",
language = "English",
volume = "117",
pages = "445--456",
journal = "THROMB HAEMOSTASIS",
issn = "0340-6245",
publisher = "Schattauer",
number = "3",

}

RIS

TY - JOUR

T1 - Prediction of severe bleeding after coronary surgery: the WILL-BLEED Risk Score

AU - Biancari, Fausto

AU - Brascia, Debora

AU - Onorati, Francesco

AU - Reichart, Daniel

AU - Perrotti, Andrea

AU - Ruggieri, Vito G

AU - Santarpino, Giuseppe

AU - Maselli, Daniele

AU - Mariscalco, Giovanni

AU - Gherli, Riccardo

AU - Rubino, Antonino S

AU - De Feo, Marisa

AU - Gatti, Giuseppe

AU - Santini, Francesco

AU - Dalén, Magnus

AU - Saccocci, Matteo

AU - Kinnunen, Eeva-Maija

AU - Airaksinen, Juhani K E

AU - D'Errigo, Paola

AU - Rosato, Stefano

AU - Nicolini, Francesco

PY - 2017/2/28

Y1 - 2017/2/28

N2 - Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m2 (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding. The WILL-BLEED score was associated with increasing rates of severe bleeding in both the derivation and validation cohorts (scores 0-3: 2.9 % vs 3.4 %; scores 4-6: 6.8 % vs 7.5 %; scores>6: 24.6 % vs 24.2 %, both p<0.0001). The WILL-BLEED score had a better discriminatory ability (AUC 0.725) for prediction of severe bleeding compared to the ACTION (AUC 0.671), CRUSADE (AUC 0.642), Papworth (AUC 0.605), TRUST (AUC 0.660) and TRACK (AUC 0.640) bleeding scores. The net reclassification index and integrated discrimination improvement using the WILL-BLEED score as opposed to the other bleeding scores were significant (p<0.0001). The decision curve analysis demonstrated a net benefit with the WILL-BLEED score compared to the other bleeding scores. In conclusion, the WILL-BLEED risk score is a simple risk stratification method which allows the identification of patients at high risk of severe bleeding after CABG.

AB - Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m2 (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding. The WILL-BLEED score was associated with increasing rates of severe bleeding in both the derivation and validation cohorts (scores 0-3: 2.9 % vs 3.4 %; scores 4-6: 6.8 % vs 7.5 %; scores>6: 24.6 % vs 24.2 %, both p<0.0001). The WILL-BLEED score had a better discriminatory ability (AUC 0.725) for prediction of severe bleeding compared to the ACTION (AUC 0.671), CRUSADE (AUC 0.642), Papworth (AUC 0.605), TRUST (AUC 0.660) and TRACK (AUC 0.640) bleeding scores. The net reclassification index and integrated discrimination improvement using the WILL-BLEED score as opposed to the other bleeding scores were significant (p<0.0001). The decision curve analysis demonstrated a net benefit with the WILL-BLEED score compared to the other bleeding scores. In conclusion, the WILL-BLEED risk score is a simple risk stratification method which allows the identification of patients at high risk of severe bleeding after CABG.

KW - Aged

KW - Area Under Curve

KW - Clinical Decision-Making

KW - Coronary Artery Bypass/adverse effects

KW - Coronary Artery Disease/blood

KW - Decision Support Techniques

KW - Europe

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Postoperative Hemorrhage/etiology

KW - Predictive Value of Tests

KW - Prospective Studies

KW - ROC Curve

KW - Registries

KW - Reproducibility of Results

KW - Risk Assessment

KW - Risk Factors

KW - Severity of Illness Index

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1160/TH16-09-0721

DO - 10.1160/TH16-09-0721

M3 - SCORING: Journal article

C2 - 27904903

VL - 117

SP - 445

EP - 456

JO - THROMB HAEMOSTASIS

JF - THROMB HAEMOSTASIS

SN - 0340-6245

IS - 3

ER -