Novel Approach of Antithrombotic Potency Amongst Patients Admitted to Hospital with Bleeding Using HEMORR2HAGES Score: A Retrospective Cohort Study

Abstract

Background: The purpose of this study was to evaluate whether a relationship exists between baseline HEMORR2HAGES score and antithrombotic potency amongst patients presenting with bleeding complication. We hypothesized that the more antithrombotic regimen potency, the less HEMORR2HAGES score you have. Methods: This is a retrospective observational study of patients admitted with a diagnosis of active bleeding between November 1, 2013 and August 31, 2015. The antithrombotic groups included patients on the following regimens: single antiplatelet therapy (SAP), single oral anticoagulant therapy (SOAC), dual antiplatelet therapy (DAPT), dual combination (SOAC+SAP), and triple antithrombotic therapy. The primary outcome was to review the mean HEMORR2HAGES score among the various groups. Results: There were a total of 180 patients in the study. No significant difference was noted among the five groups in the HEMORR2HAGES score (P = .36). The highest HEMORR2HAGES score was in the SAP group (3.23 ± 1.1). The lowest HEMORR2HAGES score was in the DAPT group (2.59 ± 1.2). In the Sub Group analysis, we compared single versus dual versus triple therapy, and we found the lowest HEMORR2HAGES score in the triple therapy group (2.70 ± 1.6); (P = .29). Conclusions: Among patients admitted with active bleeding, the HEMORR2HAGES score did not differentiate antithrombotic potency amongst groups with various regimens. This study highlights the necessity to evaluate antithrombotic therapy according to benefits and harms.