###### Created: 2024-06-09 21:01 ###### Areas & Topics: #medicine ###### Note Type: #permanent ###### Connected to: [[CHA2DS2VASc Score]] [[Atrial Fibrillation]] - The ORBIT tool is mainly used to identify people at high risk of bleeding to help guide decisions on anticoagulation. - It is a newer tool which has replaced older tools like HASBLED for evaluating patients with [[Atrial Fibrillation]] - Scores range from 0 to 7 based on the presence or absence of specific characteristics. There is a score of 2 points for: - Males with haemoglobin <130 g/L or haematocrit <40%. - Females with haemoglobin <120 g/L or haematocrit <36%. - People with a history of bleeding (for example, gastrointestinal or intracranial bleeding, or haemorrhagic stroke). There is a score of 1 point for people: - Aged over 74 years. - Who have an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73m2. - Treated with antiplatelets. ### Orbit Score Interpretation | **ORBIT score** | **Risk group** | **Bleeds per 100 patient-years** | | --------------- | -------------- | -------------------------------- | | 0-2 | Low | 2.4 | | 3 | Medium | 4.7 | | 4-7 | High | 8.1 | ### Mnemonic An informal Mnemonic to help remember the criteria of the ORBIT score include: O – Older age (age 75 or above) = 1 R – Renal impairment (GFR less than 60) = 1 B – Bleeding previously (history of gastrointestinal or intracranial bleeding) = 2 I – Iron (low haemoglobin or haematocrit) = 2 T – Taking antiplatelet medication = 1 ### Resources https://cks.nice.org.uk/topics/atrial-fibrillation/management/management-of-af/#the-orbit-bleeding-risk-tool https://www.mdcalc.com/calc/10227/orbit-bleeding-risk-score-atrial-fibrillation