ARC-HBR 고출혈위험 기준
용도사용 시기: before/at PCI when choosing stent strategy and DAPT duration.
층별Binary HBR definition (~≥4% 1-year BARC 3/5 or ≥1% ICH). More criteria → higher risk.
한계사용하지 않을 때: to withhold indicated PCI for ACS. · 함정: scoring both major and minor CKD/anemia bands for the same patien… · Pair with ischemic risk (e.g. PRECISE-DAPT context).
출처Urban P, et al. Circulation 2019 (ARC-HBR)
이번 교대 다음 단계
점수 후: 장면 연산·인접 점수·대응 경로. 로컬 참고만 — HIS 기록 없음.
방법론 · 대입 예시·가이드라인 요점·상세
적용 상황
사용 시기: before/at PCI when choosing stent strategy and DAPT duration.
입력 항목
- Major: anticipated long-term oral anticoagulation
- Major: severe/end-stage CKD (eGFR < 30)
- Major: hemoglobin < 11 g/dL
- Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent)
- Major: platelets < 100×10⁹/L
- Major: chronic bleeding diathesis
- Major: cirrhosis with portal hypertension
- Major: active malignancy (excl. nonmelanoma skin) within 12 mo
- Major: prior spontaneous ICH (any time); traumatic ICH <12 mo; bAVM; or mod/severe ischemic stroke <6 mo
- Major: nondeferrable major surgery on DAPT
- Major: major surgery or major trauma within 30 d before PCI
- Minor: age ≥ 75 y
- Minor: moderate CKD (eGFR 30–59)
- Minor: Hb 11–12.9 (men) or 11–11.9 (women) g/dL
- Minor: spontaneous bleed needing hosp/transfusion in past 12 mo (not meeting major)
- Minor: long-term oral NSAIDs or steroids
- Minor: any prior ischemic stroke not meeting major criterion
계산 방법과 공식
HBR if ≥1 major OR ≥2 minor consensus criteria (Urban 2019 table).
Check mutually exclusive CKD/Hb/bleed/stroke pairs carefully so major and minor are not double-counted inappropriately.
계산 예시 (수치 대입)
아래 수치는 본 도구의 입력 항목에 정의된 예시값이며, 이 페이지의 공식으로 서버에서 실제 계산한 결과입니다. 계산 과정을 빠르게 확인할 수 있습니다. 대입 방법을 보여주는 예시일 뿐이며 임상적 조언이 아니고 실제 사례도 아닙니다.
| Major: anticipated long-term oral anticoagulation | No (0) |
|---|---|
| Major: severe/end-stage CKD (eGFR < 30) | No (0) |
| Major: hemoglobin < 11 g/dL | No (0) |
| Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) | No (0) |
| Major: platelets < 100×10⁹/L | No (0) |
| Major: chronic bleeding diathesis | No (0) |
| Major: cirrhosis with portal hypertension | No (0) |
| Major: active malignancy (excl. nonmelanoma skin) within 12 mo | No (0) |
| Major: prior spontaneous ICH (any time); traumatic ICH <12 mo; bAVM; or mod/severe ischemic stroke <6 mo | No (0) |
| Major: nondeferrable major surgery on DAPT | No (0) |
| Major: major surgery or major trauma within 30 d before PCI | No (0) |
| Minor: age ≥ 75 y | No (0) |
| Minor: moderate CKD (eGFR 30–59) | No (0) |
| Minor: Hb 11–12.9 (men) or 11–11.9 (women) g/dL | No (0) |
| Minor: spontaneous bleed needing hosp/transfusion in past 12 mo (not meeting major) | No (0) |
| Minor: long-term oral NSAIDs or steroids | No (0) |
| Minor: any prior ischemic stroke not meeting major criterion | No (0) |
→ARC-HBRNot HBR
- Major criteria:0
- Minor criteria:0
- Rule:≥1 major OR ≥2 minor = HBR
| Major: anticipated long-term oral anticoagulation | Yes — major |
|---|---|
| Major: severe/end-stage CKD (eGFR < 30) | Yes — major |
| Major: hemoglobin < 11 g/dL | Yes — major |
| Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) | Yes — major |
| Major: platelets < 100×10⁹/L | Yes — major |
| Major: chronic bleeding diathesis | Yes — major |
| Major: cirrhosis with portal hypertension | Yes — major |
| Major: active malignancy (excl. nonmelanoma skin) within 12 mo | Yes — major |
| Major: prior spontaneous ICH (any time); traumatic ICH <12 mo; bAVM; or mod/severe ischemic stroke <6 mo | Yes — major |
| Major: nondeferrable major surgery on DAPT | Yes — major |
| Major: major surgery or major trauma within 30 d before PCI | Yes — major |
| Minor: age ≥ 75 y | Yes — minor |
| Minor: moderate CKD (eGFR 30–59) | Yes — minor |
| Minor: Hb 11–12.9 (men) or 11–11.9 (women) g/dL | Yes — minor |
| Minor: spontaneous bleed needing hosp/transfusion in past 12 mo (not meeting major) | Yes — minor |
| Minor: long-term oral NSAIDs or steroids | Yes — minor |
| Minor: any prior ischemic stroke not meeting major criterion | Yes — minor |
→ARC-HBRHBR positive
- Major criteria:11
- Minor criteria:6
- Rule:≥1 major OR ≥2 minor = HBR
결과 판독과 층별
Binary HBR definition (~≥4% 1-year BARC 3/5 or ≥1% ICH). More criteria → higher risk.
가이드라인 요점 (자체 정리)
- ≥1 major or ≥2 minor.
- Consensus criteria.
- 다음: PRECISE-DAPT / DAPT score / HAS-BLED.
이상은 해당 가이드라인의 요점을 본 사이트가 자체 정리한 것이며, 원문 인용이 아닙니다.
주의점과 한계
- 사용하지 않을 때: to withhold indicated PCI for ACS.
- 함정: scoring both major and minor CKD/anemia bands for the same patient.
- Pair with ischemic risk (e.g. PRECISE-DAPT context).
검증과 출처 · 거버넌스
참고 가이드라인과 출처
- Urban P, et al. Circulation 2019 (ARC-HBR) · 출처 ↗
자주 묻는 질문
자주 묻는 질문
- ARC-HBR 고출혈위험 기준은 환자 데이터를 업로드합니까? 어디서 계산합니까?
- 계산은 브라우저에서 로컬로 수행되며 입력과 결과는 서버로 업로드되지 않습니다. 면허 의사 참고용이며 병력·검사·소속 기관 프로토콜과 함께 해석해야 하고, 진단이나 처방을 대체하지 않습니다.
- ARC-HBR 고출혈위험 기준은 실제로 어떻게 계산합니까? 계산 예시를 보여줄 수 있습니까?
- 대입값: Major: anticipated long-term oral anticoagulation No (0), Major: severe/end-stage CKD (eGFR < 30) No (0), Major: hemoglobin < 11 g/dL No (0), Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) No (0), Major: platelets < 100×10⁹/L No (0), Major: chronic bleeding diathesis No (0), Major: cirrhosis with portal hypertension No (0), Major: active malignancy (excl. nonmelanoma skin) within 12 mo No (0)… → 결과: ARC-HBR Not HBR(Major criteria: 0, Minor criteria: 0, Rule: ≥1 major OR ≥2 minor = HBR) 대입값: Major: anticipated long-term oral anticoagulation Yes — major, Major: severe/end-stage CKD (eGFR < 30) Yes — major, Major: hemoglobin < 11 g/dL Yes — major, Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) Yes — major, Major: platelets < 100×10⁹/L Yes — major, Major: chronic bleeding diathesis Yes — major, Major: cirrhosis with portal hypertension Yes — major, Major: active malignancy (excl. nonmelanoma skin) within 12 mo Yes — major… → 결과: ARC-HBR HBR positive(Major criteria: 11, Minor criteria: 6, Rule: ≥1 major OR ≥2 minor = HBR)
검증 절차
검증과 근거
본 도구의 공식과 계산 방법은 이 페이지에 명시되어 있으며 공개적으로 대조할 수 있습니다. 공식·계수·임계값은 위 권위 출처에 따라 대조했습니다.