HAS-BLED Score
Bleeding risk on anticoagulation in atrial fibrillation.
Risk Factors
Hypertension(max +1)
Uncontrolled SBP >160 mmHg
Abnormal Renal/Liver Function(max +2)
1 point each: Dialysis/Cr>2.3, cirrhosis/bili>2×/AST/ALT>3×
Stroke(max +1)
Prior stroke history
Bleeding History(max +1)
Prior major bleeding or predisposition
Labile INRs(max +1)
Unstable/high INRs, TTR <60%
Elderly (>65)(max +1)
Age greater than 65 years
Drugs or Alcohol(max +2)
1 point each: Antiplatelets/NSAIDs, alcohol ≥8 drinks/week
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HAS-BLED Score
0 / 9
Annual Major Bleeding: 1.0%
Low Risk
Continue anticoagulation as indicated by CHA₂DS₂-VASc.
Remember: High HAS-BLED does NOT contraindicate anticoagulation. It identifies patients needing closer follow-up and risk factor modification.
Frequently Asked Questions
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