LA3CK Score for Predicting in-Hospital Mortality after Minor Bleeding in Patients with Atrial Fibrillation

Abstract Backgrounds and Purposes Minor bleeding was found to be closely related with death in in-hospital patients with atrial fibrillation (AF）and the factors affecting mortality after minor bleedings were then explored.Methods This study was divided into two parts. First, 15219 AF patients without major bleeding were included at their first hospitalizations from our centers since 2008 to 2018 to explore the association of minor bleeding with in-hospital mortality. Then factors related with in-hospital death were further explored in 789 AF patients with minor bleeding but without major bleeding and joined into one score predicting mortality after the minor bleedings during hospital stay.Results Patients with minor bleedings were at high risk of mortality (Adjusted OR:4.61, 95% CI: 3.77-5.65, p<0.001), especially if they were older (Adjusted OR:1.05, 95% CI: 1.03-1.06, p<0.001), or complicated with chronic lung diseases, chronic kidney disease stage III-V, anemia, malignant tumor, acute myocardial infarction. The c-index was 0.681 using ROC curve when these risk factors were joined into the score LA3CK. The c-index was 0.81 when this score was extended to the whole in-hospital AF population.Conclusions In the in-hospital AF patients, risk of mortality increased in patients with minor bleeding. The score LA3CK score had a good efficiency in predicting in-hospital mortality after minor bleedings.