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A Retrospective Study on the Association of Has-Bled Score with Risk of Gastrointestinal Bleeding Among Patients on Warfarin in Hospital Pakar Universiti Sains Malaysia
Abstract
Warfarin is widely used in developing countries because of its low cost and availability compared to other novel oral anticoagulants. Early prevention of anticoagulant complications such as major bleeding, particularly gastrointestinal bleeding (GIB), is essential. In Malaysia, sufficient data on the occurrence and risk factors of GIB in individuals receiving warfarin are lacking. Objectives: To evaluate the efficacy of the HAS-BLED score in prognosticating GIB events in patients who underwent warfarin therapy at Hospital USM. Methodology: In this retrospective study, patients receiving warfarin at Hospital USM between January 2017 and December 2021 were categorised as high-risk (HAS-BLED score ≥ 3) or non-high-risk (HAS-BLED score ≤ 2) based on their medical data. The association between the HAS-BLED score and the occurrence of GIB was determined using simple logistic regression. Results: Data on 138 individuals were gathered, and 25 patients (18.1%) were found to have experienced GIB. The number of patients who had a GIB event during or after six months of warfarin therapy was 16 and 9, respectively. Of the high-risk group, 24 patients (96.0%) had experienced GIB, while only one non-high-risk group member had experienced a GIB event. The results of this study suggest a significant association between HAS-BLED score and GIB events (P<0.005). Conclusion: This novel bleeding risk score adequately stratifies GIB risk and predicts GIB events among patients who have received warfarin. In this study, inclusion in the high-risk group was associated with increased GIB events.
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