Cardiology

HAS-BLED Score

Assesses bleeding risk in patients on anticoagulation therapy.

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Parameters

Uncontrolled Hypertension (SBP >160 mmHg)*

Yes, this condition applies to the patient

Abnormal Renal Function (e.g., dialysis, transplant, Cr ≥2.6 mg/dL or ≥220 µmol/L)*

Yes, this condition applies to the patient

Abnormal Liver Function (e.g., cirrhosis or bilirubin >2x ULN with AST/ALT/AP >3x ULN)*

Yes, this condition applies to the patient

History of Stroke*

Yes, this condition applies to the patient

Prior Major Bleeding or Bleeding Predisposition*

Yes, this condition applies to the patient

Labile INR (unstable/high INRs, time in therapeutic range <60%)*

Yes, this condition applies to the patient

Age ≥65 Years*

Yes, this condition applies to the patient

Concomitant Use of Medications Affecting Hemostasis (e.g., antiplatelets, NSAIDs) or Alcohol ≥8 drinks/week*

Yes, this condition applies to the patient

HAS-BLED Score Result

FormulaSum of points for each present risk factor (max 9)

Clinical Pearls

A high HAS-BLED score should not be used as a reason to withhold anticoagulation in AF patients at risk of stroke, but rather to address modifiable risk factors and ensure regular monitoring.

Normal Values / Reference

Score of 0–2 is generally considered low-to-moderate risk; ≥3 indicates high risk of major bleeding.

Limitations

Does not predict absolute bleeding risk over time; does not account for all possible bleeding risk factors (e.g., genetic factors, frailty). Clinical judgment remains essential.