Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Log In

    Show
    Forgot your password?
    Log In
    Or create a new account (it's free)

    Forgot Password?

    Enter your email address and we'll send you a link to reset your password.

    Get New Password

    Sign In Required

    To save favorites, you must log in.

    Creating an account is free, easy, and takes about 60 seconds.

    Already have an MDCalc account?

    Login to link your favorites and recently used calcs

    Show
    Forgot your password?
    Log In
    Or continue to Nuance

    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    ORBIT Bleeding Risk Score for Atrial Fibrillation

    Predicts bleeding risk in patients on anticoagulation for afib, similar to HAS-BLED.

    INSTRUCTIONS

    Use in adult patients with atrial fibrillation, to assess risk of major bleeding with anticoagulation.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with atrial fibrillation in whom anticoagulation is being considered for stroke prevention.

    • Major bleeding was defined as fatal bleeding, symptomatic bleeding in a critical organ, or bleeding with a hemoglobin drop requiring transfusion of ≥2 units (ISTH criteria).

    • ORBIT does not take into account choice of anticoagulant. 

    • Unlike HAS-BLED, ORBIT does not take into account the time in therapeutic range, as there is no reliable or readily available objective measure for therapeutic range of the direct oral anticoagulants (DOACs).

    • Unlike HAS-BLED, ORBIT was derived in a patient population that included vitamin K antagonists (VKAs, such as warfarin) as well as DOACs.

    • May be used in conjunction with the CHA₂DS₂-Vasc Score to risk stratify patients for clinically significant bleeding to help guide decisions on anticoagulation in patients with atrial fibrillation.

    • May not be statistically superior to HAS-BLED (see Evidence for details), but was more recently derived and validated in the era of DOACs, and may be more useful for that reason.

    Male
    Female
    No
    0
    Yes
    +1
    No
    0
    Yes
    +2
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Dr. Emily C. O’Brien

    About the Creator

    Emily C. O’Brien, PhD, is an assistant professor in population health sciences and neurology at Duke University in Durham, North Carolina. She is also a researcher in the Duke Clinical Research Institute. Dr. O’Brien’s primary research is focused on outcomes in cardiovascular and pulmonary disease.

    To view Dr. Emily C. O’Brien's publications, visit PubMed

    Content Contributors
    About the Creator
    Dr. Emily C. O’Brien
    Also from MDCalc...
    You might be interested in...
    Partner Content
    Calculated Decisions: ORBIT

    Emergency Medicine Practice

    Content Contributors