Comparison of Different Bleeding Risk Scores to Predict in-Hospital Major Bleeding in Patients with Acute Pulmonary Embolism who Underwent Thrombolytic Treatment
1Department of Cardiology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
2Department of Cardiology, Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
3Department of Cardiology, Health Sciences University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, İstanbul, Turkey
J Clin Pract Res 2020; 42(1): 37-43 DOI: 10.14744/etd.2019.59480
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Abstract

Objective: Certain bleeding risk scores have been proposed to predict major bleeding (MB) events in patients with acute pulmonary embolism (APE) during anticoagulation therapy. Since patients who undergo thrombolytic treatment are usually excluded from such studies, it is unknown whether these scores may provide an adequate prognostic value for in-hospital major MB. Consequently, we evaluated some well-known bleeding scores to predict in-hospital MB in patients with APE who were treated with thrombolytic therapy.
Materials and Methods: A total of 99 consecutive patients with APE who underwent thrombolytic therapy from June 2011 to August 2015 were included in the retrospective study. For each patient, we estimated the bleeding risk using the Kuijer, Riete, Atria, Has-Bled, and PRECISE-DAPT scores.
Results: In total, 22 MB events occurred in 99 (19%) patients following admission. A receiver operating characteristic curve analysis showed that the PRECISE-DAPT score might have an adequate prognostic value for MB (area under curve [AUC] value, 0.770). Meanwhile, the other abovementioned risk scores had poor predictive values (AUC values, 0.612–0.658) for MB.
Conclusion: Despite being developed and validated to determine MB in patients receiving dual antiplatelet treatment, the PRECISE-DAPT score may be useful in estimating the risk of MB in patients with APE who underwent thrombolytic therapy.