hemorr2hages_score: HEMORR2HAGES Score for Major Bleeding Risk

In cliot: Clinical Indices and Outcomes Tools

HEMORR2HAGES Score for Major Bleeding Risk

Description

Calculates the HEMORR2HAGES score to estimate the risk of major bleeding in elderly patients with atrial fibrillation who are taking warfarin. This score is considered more sensitive than CHADS2 for identifying bleeding risk in this specific population.

Usage

hemorr2hages_score(hepatic_renal_disease, ethanol_abuse, malignancy, age_gt_75,
                   reduced_platelets_function, prior_bleed, hypertension, anemia,
                   genetic_factors, fall_risk, stroke_history)

Arguments

hepatic_renal_disease	Numeric (0 or 1). Hepatic or Renal Disease. (1 = Yes, +1 point).
ethanol_abuse	Numeric (0 or 1). Ethanol (Alcohol) Abuse. (1 = Yes, +1 point).
malignancy	Numeric (0 or 1). History of Malignancy. (1 = Yes, +1 point).
age_gt_75	Numeric (0 or 1). Age > 75 years. (1 = Yes, +1 point).
reduced_platelets_function	Numeric (0 or 1). Reduced platelet count or function (e.g., Aspirin use). (1 = Yes, +1 point).
prior_bleed	Numeric (0 or 1). History of prior bleeding (Re-bleeding risk). (1 = Yes, +2 points).
hypertension	Numeric (0 or 1). Uncontrolled Hypertension. (1 = Yes, +1 point).
anemia	Numeric (0 or 1). Anemia. (1 = Yes, +1 point).
genetic_factors	Numeric (0 or 1). Genetic factors (e.g., CYP2C9 polymorphisms). (1 = Yes, +1 point).
fall_risk	Numeric (0 or 1). Excessive Fall Risk. (1 = Yes, +1 point).
stroke_history	Numeric (0 or 1). History of Stroke. (1 = Yes, +1 point).

Value

A list containing:

HEMORR2HAGES_Score	The calculated score (Range 0-12).
Risk_Category	Classification (Low, Intermediate, High).
Bleeding_Risk_per_100_Pt_Years	Estimated number of major bleeds per 100 patient-years.

References

Gage BF, Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719. doi:10.1016/j.ahj.2005.04.017

Examples

# Example 1: High Risk
# Prior Bleed (+2), Age >75 (+1), HTN (+1)
# Score = 4
hemorr2hages_score(0, 0, 0, 1, 0, 1, 1, 0, 0, 0, 0)

# Example 2: Low Risk
# No risk factors
# Score = 0
hemorr2hages_score(0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.