Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome

pp. 167-172

Abstract

Background: Major bleeding is the most important complication of antithrombotic treatment in acute coronary syndrome (ACS) and is associated with higher mortality. Assessing the risk of bleeding is a challenge. The usefulness of the Orbit Bleeding Score (ORBIT) to assess the risk of bleeding in ACS has been scarcely studied.
Objective: The aim of this study was to evaluate the ORBIT score as a predictor of major bleeding in patients hospitalized for ACS in whom anticoagulation is decided as part of the antithrombotic strategy.
Methods: Patients admitted to two coronary care units with diagnosis of ACS who received anticoagulation as part of the antithrombotic therapy were retrospectively included in the study. The CRUSADE, ACTION-GWTG and ORBIT scores were calculated using the admission clinical data. The primary endpoint was major bleeding, defined as BARC 3 or 5 classification.
Results: The study included 762 patients. Major bleeding occurred in 3.4% of cases. In the univariate analysis, the three scores
were predictors of major bleeding, while in the multivariate analysis only the ORBIT score was an independent predictor of major bleeding (OR: 2.46, 95% CI 1.61-3.97, p <0.001). The area under the ROC curve was 0.70, 0.68 and 0.80 for the ACTION-GWTG, CRUSADE and ORBIT scores, respectively. The ORBIT score presented a higher area under the curve than the CRUSADE score (p=0.03) but without significant difference with the ACTION-GWTG score (p=0.06).
Conclusions: The ORBIT score was the only independent predictor of major bleeding, presenting a better discrimination capacity than the CRUSADE score and a tendency to better capacity than the ACTION-GWTG score.

How to cite this article:

Chirino Navarta DA, Pinel S, Vitale FL, Iglesias JS, Leonardi M, Tellechea FE, et al. Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome. Rev Argent Cardiol 2022;90:167-72. http://dx.doi.org/10.7775/rac.v90.i3.20521