Risk Scores Flashcards
(36 cards)
Purpose of QRISK3
Calculates risk of developing a heart attack or stroke over the next 10 years.
What does a QRISK3 score over more than 20 suggest?
High risk of developing CVD in the next 10 years.
What is moderate risk score on QRISK3?
10-20%
What non-clinical factors are looked at on the QRISK3 score?
- Age
- Sex
- Ethnicity
- Postcode
What clinical factors are looked at on the QRISK3 score?
- Smoking status
- Diabetes status
- Angina/MI in 1st degree relative <60
- CKD stage 3, 4, 5
- AF
- BP management medication
- Migraines
- SLE
- Severe mental illness/ atypical antipsychotic meds
- Steroids
- Erectile dysfunction treatment
What investigation results are looked at on the QRISK3 score?
- Cholesterol/HDL ratio
- Systolic BP
- BMI
What does the CHADS2VASc score show?
Risk of stroke in those with AF
What are the factors in the CHADS2VASc score?
- Congestive HF/LVSD
- HTN >140/90
- Age >75 = 2 points
- DM
- Prior Stroke (2), TIA(1) or thromboembolism
- Vascular disease e.g. peripheral artery disease, MI, aortic plaque
- Age 65-74 = 1 point
- Sex - Female
Features of the HAS-BLED?
- Hypertension
- Abnormal renal/liver function
- Stroke
- Bleeding
- Labile INR (unstable)
- Elderly
- Drugs or alcohol
What does HAS-BLED show?
Assess 1 year risk of major bleeding in patients taking anticoagulants with atrial fibrillation.
Why use Well’s score for DVT?
Rule out the need for US to diagnose DVT
Features of Well’s score for DVT?
- Active cancer
- Bedridden recently >3 days or major surgery within 12 weeks
- Calf swelling >3cm compared to other leg
- Collateral superficial veins present
- Entire leg swollen
- Localised tenderness along the deep venous system
- Pitting oedema - single leg
- Paralysis, paresis or recent plaster immobilisation
- Previously documented DVT
What suggests score of moderate risk in DVT?
1-2
What suggests score of high risk in DVT?
> 2
What to do if moderate risk in DVT Well’s score?
- High sensitivity D dimer testing
- -> if negative then no worries
- -> if positive proceed to US
What to do if high risk in DVT Well’s score?
Should receive diagnostic US
Why use Well’s score for PE?
To reduce number of people getting a CT pulmonary agniogram.
Features of Well’s score for PE?
- Clinical signs and symptoms of DVT
- PE = #1 diagnosis or equally likely
- HR >100
- Immobilisation at least 3 days or surgery in the previous 4 weels
- Previously objectively diagnosed PE/ DVT
- Haemoptysis
- Malignancy w/ treatment within 6 months or palliative
What is moderate risk in PE Well’s score?
2-6 If D dimer negative consider stopping work up
If D dimer positive consider CTA.
What is high risk in PE Well’s score?
> 6 –> consider CTA
Features of Diabetes Risk Score
- Gender
- Age
- Ethnicity
- 1st degree relative with diabetes
- Waist size
- BMI
- BP or BP medications
What is low risk on Diabetes Risk Score
0-6
What is increased risk in Diabetes Risk Score
7-15 - make lifestyle changes
What is moderate risk in Diabetes Risk Score
16-24 - see GP and discuss risk and how to reduce
