title: Use of the CRUSADE bleeding risk score in the prediction of major bleeding for patients with acute coronary syndrome receiving enoxaparin in Thailand.
abstract: BACKGROUND
  CRUSADE risk score stands out as a simple-to-use bleeding risk model. However, its use is still doubtful for Thai population. The aim of this study was to assess the prognostic value of CRUSADE in predicting risk of major bleeding among Thai patients with acute coronary syndrome (ACS) receiving enoxaparin.
  
  
  METHODS
  A retrospective cohort study was performed using patients with ACS who were hospitalised at a university hospital in Bangkok between 2006 and 2009 and had received enoxaparin. The CRUSADE risk score was calculated. The model validation was tested by using C statistic and Hosmer-Lemeshow goodness-of-fit.
  
  
  RESULTS
  The overall incidence of major bleeding was 18.3%. Median CRUSADE score for entire study population, unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI) were 49, 47, 53, and 39, respectively. Hosmer-Lemeshow goodness of fit revealed no statistical significance in all groups. The CRUSADE model demonstrated a satisfactory discriminatory capacity for the entire study population (C = 0.688), UA (C = 0.591), NSTEMI (C = 0.693), and STEMI groups (C = 0.736).
  
  
  CONCLUSIONS
  Across the ACS spectrum, CRUSADE risk score was able to estimate in-hospital major bleeding of Thai patients with ACS who received treatment with enoxaparin. The application of these results in Thailand may be helpful in the identification of patients at high bleeding risk and also may lead to implementation of appropriate prevention.
authors.affiliation: Pharmacy Practice Division, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Thailand.
authors.forename: Peerawat
authors.initials: P
authors.lastname: Jinatongthai
authors.affiliation: Phayathai 3 Hospital, Bangkok, Thailand.
authors.forename: Narinee
authors.initials: N
authors.lastname: Khaisombut
authors.affiliation: Divisions of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
authors.forename: Khanchit
authors.initials: K
authors.lastname: Likittanasombat
authors.affiliation: School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; School of Pharmacy, University of Wisconsin, Madison, USA; School of Population Health, University of Queensland, Brisbane, Australia.
authors.forename: Nathorn
authors.initials: N
authors.lastname: Chaiyakunapruk
authors.affiliation: Pharmacy Practice Division, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Thailand.
authors.forename: Sawaeng
authors.initials: S
authors.lastname: Watcharathanakij
authors.affiliation: Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Thailand. Electronic address: pysnt@mahidol.ac.th.
authors.forename: Surakit
authors.initials: S
authors.lastname: Nathisuwan
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000453:epidemiology; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013785:Thailand
chemical_list: D017984:Enoxaparin; D005343:Fibrinolytic Agents
keywords: Acute coronary syndrome; CRUSADE risk score; Enoxaparin; Major bleeding; Thailand