About

The CRUSADE Bleeding Risk Score identifies patients with non-ST-segment elevation myocardial infarction (NSTEMI) who are at high risk of major in-hospital bleeding. Bleeding complications in ACS are associated with increased mortality, often comparable to ischemic events. This tool allows clinicians to balance the intensity of antiplatelet and antithrombotic therapy against the risk of hemorrhage. It utilizes 8 independent predictors derived from over 71,000 patients in the CRUSADE registry, including a baseline hematocrit and calculated creatinine clearance.

Formulas

Creatinine Clearance (CrCl) is calculated first via Cockcroft-Gault:

CrCl = 140 − Age × Weight72 × SCr × 0.85 (if Female)

Points are then assigned for:

Baseline Hematocrit < 31% → 9 ptsCrCl < 15 mL/min → 39 ptsHeart Rate > 120 bpm → 11 ptsSigns of CHF → 7 pts

Reference Data

Risk Category	CRUSADE Score	Bleeding Probability
Very Low	≤ 20	3.1%
Low	21 - 30	5.5%
Moderate	31 - 40	8.6%
High	41 - 50	11.9%
Very High	> 50	19.5%

Frequently Asked Questions

The CRUSADE score was derived specifically from NSTEMI populations. While sometimes applied to STEMI, validation is less robust than for NSTEMI.

History of Peripheral Artery Disease (PAD) or prior Stroke.

The scoring algorithm caps CrCl points. Values > 120 mL/min receive 0 points. The risk increases as CrCl drops, with the maximum penalty (39 points) for CrCl ≤ 15 mL/min.