A stroke risk score in atrial fibrillation is not a one-off label. Age thresholds, a new diagnosis of hypertension or diabetes, or a heart failure admission all add points, and a patient judged low risk at diagnosis often crosses into the anticoagulation range within a few years.
Recording the score and its date at each annual review, and after any admission, catches the patient whose risk has quietly risen. The same review is the moment to recheck renal function and weight for DOAC dosing.
- Recalculate the stroke risk score at each annual review and after every admission.
- Look specifically for new hypertension, diabetes, heart failure or a birthday crossing 65 or 75.
- Recheck creatinine clearance and weight when reviewing DOAC dose.
- Record the score and date in the notes so the next clinician can see the trend.
Why it matters
A patient left off anticoagulation may have been assessed correctly once and never since.
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