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)

1


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:


Hypertension

Abnormal renal and liver function

Stroke

Bleeding

Labile INR

Elderly

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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