HAS-BLED Score

Assess major bleeding risk in patients receiving anticoagulation.

Risk Factors

Hypertension (Systolic BP > 160)Abnormal Renal Function (Cr > 2.26 mg/dL or transplant/dialysis)Abnormal Liver Function (Cirrhosis or elevated AST/ALT/Bili)Stroke HistoryPrior Major Bleed or Predisposition (e.g., anemia)Labile INR (TTR < 60% for patients on Warfarin)Elderly (Age > 65)Drugs (NSAIDs or Antiplatelets)Alcohol (≥ 8 drinks/week)

Bleeding Risk Assessment

HAS-BLED Score0Points

Bleeding Risk1.1% / yearEstimated

Low/Moderate Risk

Anticoagulation generally well-tolerated if indicated.

High score is NOT a reason to withhold anticoagulation but a reason to manage risk factors.

About this calculator

Overview

The HAS-BLED score is a tool designed to estimate the 1-year risk of major bleeding in patients with atrial fibrillation who are starting or already taking anticoagulants. It helps clinicians balance the benefits of stroke prevention against the potential harm of gastrointestinal or intracranial hemorrhage.

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Pro Tips

Correct hypertension (target SBP < 140) to lower the HAS-BLED score.
Advise patients to avoid NSAIDs like Ibuprofen while on anticoagulants.
Review alcohol intake; reducing to < 8 drinks/week can remove 1 point from the score.

Fun Facts

"A score ≥ 3 indicates 'high risk,' requiring caution and regular clinical review."
"Major bleeding is defined as intracranial hemorrhage, bleeding requiring hospitalization, or a drop in hemoglobin ≥ 2 g/dL."
"The score should not be used to withhold anticoagulation but to identify modifiable risk factors."
"NSAID use is a significant modifiable risk factor captured in this score."

Formula: 1 point for each factor: H (Hypertension), A (Abnormal renal/liver), S (Stroke), B (Bleeding), L (Labile INR), E (Elderly), D (Drugs/Alcohol).