Risk Scores Flashcards
What is QRISK
The risk of someone having a cardiovascular event in the next 10 years.
What is included in the QRISk score?
Age, sex, ethnicity, postcode, smoker, diabetes, angina or heart attack in first degree relative <60, CKD, AFib, on BP treatment, migraines, rheumatoid arthritis, SLE, BP, BMI, on steroid medication
What is CHADs2VASc?
the risk of stroke in patients with atrial fibrillation
What is included in the CHADs2VASc score?
CHF (1), HTN (1), age >75 (2), DM (1), prior stroke or TIA (2), vascular disease (1), age 65-74 (1), female (1)
What is the FRAX score?
Used to evaluate risk of a fracture in the next 10 years
What is included in a FRAX score?
age, sex, weight, height, previous fracture, parent fractured a hip, current smoking, use of glucocorticoids, rheumatoid arthritis, secondary osteoporosis, three or more alcoholic drinks a day, bone mineral density
What is the ABCD2 score?
the risk of having a stroke following a TIA
What is included in an ABCD2 score?
Age >60 years (1)
BP >140/90 (1)
Clinical features of TIA
- unilateral weakness (2)
-speech disturbance without weakness (1)
Duration of symptoms
- <10mins (0)
- 10-59mins (1)
- >60mins (2)
Diabetes (1)
What is Wells Score?
risk of developing DVT
What is included in Wells Score?
-Active cancer or cancer in last 6 months (1)
-paralyzed leg (1)
-recently bedridden or surgery in last 4 weeks (1)
-tenderness near deep vein (1)
-swollen leg (1)
- swollen calf of diameter >3cm compared to the other calf (1)
-pitting oedema (1)
-large veins that aren’t varicose veins in the leg (1)
-previously diagnosed DVT (1)
What are the scores and management for CHADVASC2?
Score 0: no anticoagulant required
Score 1: consider anticoagulant eg warfarin
Score 2+: anticoagulant required or a DOAC eg apixaban
What are the scores and management for QRISK2?
<10%: low risk but still consider lifestyle changes eg stop smoking, improve diet, increase exercise, improve medication adherence
> 10%: increased risk of cardiovascular event. Offer advice on any relevant lifestyle factors, review comorbidities to control better, discuss benefits of lipid therapy eg statins
What are the scores and management for the FRAX score?
<10%: low risk but give lifestyle advice eg stop smoking, reduce alcohol intake, more weight bearing exercise, increase calcium and vitamin D in diet, have shoes with good grip to reduce falls
10%-20%: intermediate risk. DEXA scan and give alendronic acid (a bisphosphonate)
> 20%: high risk. Treat as above plus modify risk factors and review in 10 years.
What are the scores and management for ABCD2?
Score <3: see within 7 days
Score 4-6: specialist to see within 24 hours
Score >6: specialist referral immediately
Management: 300mg aspirin immediately then 75mg long term. Clopidogrel 75mg. Plus control lifestyle factors and HTN
What are the scores and management for wells score?
Score <0: DVT unlikely
Score 1-2: DVT risk moderate manage by doing d-dimer
Score >3: DVT likely and do doppler US
D-Dimer isn’t diagnostic if positive as can be caused by many different things eg malignancy, heart failure, pregnancy, surgery
Doppler US is diagnostic
