HAS-BLED score
One-year major bleeding risk on anticoagulation for atrial fibrillation.
Inputs
HypertensionUncontrolled, systolic above 160 mmHg
Abnormal renal functionDialysis, transplant, or Cr ≥2.26 mg/dL
Abnormal liver functionCirrhosis, or bilirubin >2× and AST/ALT >3× normal
Stroke history
Prior major bleeding or predisposition
Labile INRTime in therapeutic range below 60%
ElderlyAge above 65
Antiplatelet or NSAID use
Alcohol use8 or more drinks per week
Worked calculation
Your values are highlighted.
- Points
When to use
- Patients with AF on or considering anticoagulation.
Pearls and pitfalls
- A high score flags modifiable risks to address; it is not by itself a reason to withhold anticoagulation.
Why use
Points shown so you can target modifiable items.
| Criterion | Points |
|---|---|
| Hypertension | +1 |
| Abnormal renal function | +1 |
| Abnormal liver function | +1 |
| Stroke history | +1 |
| Prior major bleeding or predisposition | +1 |
| Labile INR | +1 |
| Elderly | +1 |
| Antiplatelet or NSAID use | +1 |
| Alcohol use | +1 |
A score of 3 or more indicates high risk and calls for closer follow-up and correction of modifiable factors.