HEMORR₂HAGES bleeding risk
Bleeding risk on warfarin in older patients with atrial fibrillation.
Inputs
Hepatic or kidney disease
Ethanol abuse
Malignancy
Older than 75
Reduced platelet count or functionIncludes aspirin use
Prior bleeding
Uncontrolled hypertension
Anemia
Genetic factorsCYP2C9 variants
Excessive fall risk
Stroke
Worked calculation
Your values are highlighted.
- Points
When to use
- Estimating bleeding risk before or during warfarin therapy.
Pearls and pitfalls
- Use to find modifiable risks, not to withhold anticoagulation by itself.
- HAS-BLED is simpler and more widely used.
Why use
Includes genetic and fall-risk factors that HAS-BLED omits.
| Criterion | Points |
|---|---|
| Hepatic or kidney disease | +1 |
| Ethanol abuse | +1 |
| Malignancy | +1 |
| Older than 75 | +1 |
| Reduced platelet count or function | +1 |
| Prior bleeding | +2 |
| Uncontrolled hypertension | +1 |
| Anemia | +1 |
| Genetic factors | +1 |
| Excessive fall risk | +1 |
| Stroke | +1 |