HAS-BLED score

HAS-BLED is a scoring system developed to assess 1-year risk of major bleeding in patients taking anticoagulants with atrial fibrillation. 

Major bleeding is defined as being intracranial bleedings, hospitalization, hemoglobin decrease > 2 g/dL, and/or transfusion.

Condition Points:

 H  Hypertension: (uncontrolled, >160 mmHg systolic) 1

 A Abnormal renal function: Dialysis, transplant, Cr >2.26 mg/dL

Abnormal liver function: Cirrhosis or Bilirubin >2x Normal or AST/ALT/AP >3x Normal 1

 S Stroke: Prior history of stroke 1

 B Bleeding: Prior Major Bleeding or Predisposition to Bleeding 1

L Labile INR: (Unstable/high INR), Time in Therapeutic Range < 60% 1

 E Elderly: Age > 65 years 1

 D Prior Alcohol or Drug Usage History (≥ 8 drinks/week)

Medication Usage Predisposing to Bleeding: (Antiplatelet agents, NSAIDs)


A calculated HAS-BLED score is between 0 and 9 and based on seven parameters with a weighted value of 0-2.

The HAS-BLED mnemonic stands for:


Abnormal renal and liver function



Labile INR


Drugs or alcohol

Guidelines on atrial fibrillation care recommend assessment of bleeding risk in AF using the HAS-BLED bleeding risk.

A score of ≥3 indicates high risk.

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