HAS-BLED score

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A therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation[1]. It is matched to the CHA2DS2-VASc score used for stroke risk stratification but has not as of 2010 been externally validated.

HAS-BLED score for bleeding risk on oral anticoagulation in atrial fibrillation
Feature Score if present
Hypertension (Systolic ≥ 160mmHg) 1
Abnormal renal function 1
Abnormal liver function 1
Age ≥ 65 years 1
Stroke in past 1
Bleeding 1
Labile INRs 1
Taking other drugs as well 1
Alcohol intake at same time 1

A score of 3 or more indicates increased one year bleed risk on anticoagulation sufficient to justify caution or more regular review. The risk is for intracranial bleed, bleed requiring hospitalization or a haemoglobin drop > 2g/L or that needs transfusion.