HAS-BLED score
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Editors-in-Chief: Gregory Lip, MD [1] and C. Michael Gibson, M.S., M.D. [2]
Overview
A therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation[1]. It is matched to the CHA2DS2-VASc score used for stroke risk stratification but has not as of 2010 been externally validated.
| Feature | Score if present |
|---|---|
| Hypertension (Systolic ≥ 160mmHg) | 1 |
| Abnormal renal function | 1 |
| Abnormal liver function | 1 |
| Age ≥ 65 years | 1 |
| Stroke in past | 1 |
| Bleeding | 1 |
| Labile INRs | 1 |
| Taking other drugs as well | 1 |
| Alcohol intake at same time | 1 |
Interpretation of the HAS-BLED Score
A score of 3 or more indicates an increased one year bleed risk on anticoagulation which would be sufficient to justify caution or more frequent evaluation. The risk is the risk of an intracranial bleed, bleeding requiring hospitalization or a hemoglobin drop > 2g/L or a bleeding episode that requires transfusion.