HAS-BLED Score for Major Bleeding Risk

Estimates risk of major bleeding for patients on anticoagulation to help determine risk-benefit in atrial fibrillation care.

Hypertension History? (uncontrolled, >160 mmHg systolic) +1
Renal Disease? (Dialysis, transplant, Cr >2.6 mg/dL or >200 µmol/L) +1
Liver Disease? (Cirrhosis, Bilirubin >2x Normal, AST/ALT/AP >3x Normal) +1
Stroke History? +1
Prior Major Bleeding or Predisposition to Bleeding? +1
Labile INR? (Unstable/high INRs, +1
Age ≥65? +1
Medication Usage Predisposing to Bleeding? (Antiplatelet agents, NSAIDs) +1
Alcohol Usage History? +1
Patient has none of these
Score points
Points are simply added, with 1 point for each question.

There are recommendations to use the HAS-BLED Score with the CHA2DS2-VASc Score to help determine if anticoagulation is in the best interest of a particular patient. "Major bleeding" was defined in the HAS-BLED study as "intracranial, [requiring] hospitalization, hemoglobin decrease > 2 g/L, and/or transfusion."

"HAS-BLED" is an acronym for:

  • Hypertension
  • Abnormal Liver/Renal Function
  • Stroke History
  • Bleeding Predisposition
  • Labile INRs
  • "Elderly" (Age >e; 65)
  • Drugs/Alcohol Usage

Posted in: CardiacCardiology









The NNT : Quick Summaries of Evidence-Based Medicine