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Cardiology

HAS-BLED

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Formula

One point each: H, A (renal and liver: 1 each), S, B, L, E (age over 65), D (drugs and alcohol: 1 each). Maximum 9.

Limitations

  • A score of 3 or more flags a high bleeding risk to prompt review of modifiable factors; it is not a reason in itself to withhold anticoagulation.
  • Only a score of 3 or more is defined as high risk in the sources; the 0 and 1-2 groups are display groupings of this tool (published major-bleeding rates rise with each additional point).

References

  1. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, Lip GYH. Chest. 2010;138(5):1093-1100. PMID 20299623