Table 3

Anticoagulant treatment strategy in hospitalised patients with AF per specialty, according to CHA2DS2-VASc-score

ZoneWard specialtySurgical specialtyAll patientsPatients with AFCHA2DS2-VASc-score* 
0 (n=2)1 (n=6)≥2 (n=99) 
AOUAUAOUO
Thorax
Respiratory medicine 2341†
2‡		1§1†: Postoperative AF (12 h postoperative)
1‡: Palliative care
1‡: No reason+coronary disease
Thoracic surgeryx 1511¶1¶: Patient refuses to take VitK
Respiratory medicinex 1521§1**1§: Pulmonary embolism
Respiratory medicine 1111¶1¶: Fall risk
Cardiovascular medicine 1511‡1‡: Hydrea therapy for thrombocytosis+coronary disease
Cardiovascular medicine 2081¶6**1††1¶: Haemophilia B1††: Coronary disease
Cardiovascular surgeryx 1782†4**1‡‡
1§§		2†: No reason1‡‡: Stent superficial femoral artery.
1§§: Endoprosthesis
Cardiac surgeryx 20134†
1‡		1**1¶¶
6‡‡		2†: Postoperative AF (≥72 h postoperative)+coronary disease
1†: No reason+valve replacement
1†: Postoperative AF (≥72 h postoperative)+valve replacement
1‡: No reason+coronary disease		1¶¶: Endoprosthesis+coronary disease
2‡‡: Valve replacement +coronary disease
2‡‡: Valve replacement
2‡‡: Coronary disease
Cardiovascular medicinex 2182‡
1†		4**1‡‡1‡: Fall risk+coronary disease
1‡: Non-adherence+history of bleeding
1†: Fall risk		1‡‡: Coronary disease
Internal medicine
Rheumatology/ Endocrinology 220
Geriatric medicine 2283†5**1†: Patient refuses to take VitK+non-adherence
1†: Palliative care
1†: No reason
Geriatric medicine 2172†
1‡		1**
1 (d)		1‡‡
1¶¶		1†: History of bleeding+fall risk
1†: Age+fall risk
1‡: Patient refuses to take VitK+coronary disease		1‡‡: Coronary disease
1¶¶: Reason unclear
Neurology 170
Stroke-unit 1421¶1 (d)1¶: History of bleeding
General internal medicine 2421¶1**1¶: Fall risk+palliative care
Geriatric medicine 18111¶5**
3§
1 (d)		1‡‡1¶: Agè1‡‡: Coronary disease
Abdomen
Kidney/liver transplantationx 2021¶
1†		1¶: Postoperative AF (≥72 h postoperative)
1†: No reason
Nephrology 821‡1¶¶1‡: Non-adherence+history of bleeding
+coronary disease		1¶¶: Reason unclear
Gastroenterology 1931†1†1**1†: No reason
Abdominal surgeryx 190
Abdominal surgeryx 2711**
Gastroenterology/ hepatology/ abdominal surgeryx 170
Hepatology 2121§1 (d)
Oncology
Oncology 2121§1¶¶1¶¶: Pulmonary embolism+palliative care
Oncology 1331¶1**
1§		1¶: No reason
Haematology 1621¶1¶1¶: Thrombopenia
Oncology surgery / Multidisciplinary breast centrex 1611**
Gastroenterology and Hepatology 1831†2 (d)1†: No reason
Haematology 110
Locomotor system
Neurosurgeryx 190
Traumatologyx 1522**
Plastic and reconstructive surgeryx 1811¶¶1¶¶: Reason unclear
Reproduction and growth
Urologyx 110
Urologyx 2031§1§1***1***: Coronary disease
Gynaecologyx 2311**
Sensory sytem
Ear, Nose and Throat / Stomatologyx 931**2**
Total36 wards1763610711153249183319

  • *Guideline recommendations:

  • CHADSVASc=0 → aspirin or no antithrombotic treatment.

  • CHADSVASc=1 → aspirin or oral anticoagulation.

  • CHADSVASc≥2 → oral anticoagulation.

  • †ASA.

  • ‡Double antiplatelet therapy.

  • §LMWH.

  • ¶No treatment.

  • **VitK; (d) Dabigatran.

  • ††VitK+Clopidogrel.

  • ‡‡VitK+ASA.

  • §§Rivaroxaban+ASA.

  • ¶¶LMWH+ASA.

  • ***VitK+ASA+Clopidogrel.

  • A, appropriate treatment; ASA, aspirin; O, possible overtreatment; OAC, oral anticoagulation; U, untreatment; VitK, vitamin K antagonist.