At intermediate risk the score itself is the weak point. A male score of 1 (or female 2) often rests on a single item that was never confirmed: hypertension from one clinic reading, or 'vascular disease' from a trivial plaque. Re-check the item before treating on it.
The other half is bleeding. Correct modifiable bleeding risks — uncontrolled blood pressure, NSAID use, alcohol, unnecessary antiplatelets — and record renal function and weight for DOAC dosing.
- Confirm the single risk factor that makes the score 1 in men or 2 in women.
- Stop concomitant NSAIDs and antiplatelets without a clear indication.
- Check creatinine clearance and weight for DOAC dose selection.
- Recalculate the score annually; age 65 moves a patient up.
Why it matters
At intermediate risk a single misrecorded risk factor decides the treatment.
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