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Professional Reference tools are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines, so you may find the language more technical than the condition leaflets.

The ORBIT Score estimates the risk of major bleeding for patients on anticoagulation for atrial fibrillation (AF). This has now replaced the HAS-BLED calculator in estimating risk as evidence shows that it has a higher accuracy in predicting absolute bleeding risk than other bleeding risk tools.

 Go to the ORBIT Score for Major Bleeding Risk.

Notes

Clinical factors that contribute to stroke risk and support anticoagulation in patients with AF are frequently risk factors for bleeding as well. The evidence has shown that ORBIT is more accurate than HASBLED and ATRIA at predicting absolute risk of major bleeding, both for people using vitamin K antagonists (warfarin) and those using directacting oral anticoagulants (DOACs). ORBIT is also better at predicting absolute risk of intracranial haemorrhage.

A potential challenge is that ORBIT is not the recommended bleeding risk tool for other conditions (such as venous thromboembolism).

The National Institute for Health and Care Excellence (NICE) updated its guidance for the diagnosis and management of atrial fibrillation in 2021 recommending that this scoring tool be used instead of HAS-BLED when considering starting anticoagulation in people with AF, and when reviewing people already taking anticoagulation.

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Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

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