HAS-BLED bleeding risk score

Clinical feature /   Points

H Hypertension -( systolic blood pressure >160 mmHg) (Points: 1 )

A Abnormal renal function ( defined as the presence of chronic dialysis or renal transplantation                   or serum creatinine 200µmol/L (>~2.3 mg/dL)) (Points: 1 )     Abnormal liver function ( defined as chronic hepatic disease (eg. cirrhosis) or biochemical               evidence of significant hepatic derangement (eg. bilirubin >2x upper limit of normal, in association               with AST/ALT/ALP >3x upper limit normal) (Points: 1 )

S Stroke (Previous history of stroke) (Points: 1 )

B Bleeding (Major bleeding history (anemia or predisposition to bleeding))  (Points: 1 )

L Labile INRs (refers to unstable/high INRs or poor time in therapeutic range(eg<60%))(Points: 1)

E Elderly (age >/= 65) (Points: 1 )

D Drug Therapy (concomitant therapy such as antiplatelet agents, NSAID's)   (Points: 1 )     Alcohol intake (consuming 8 or more alcoholic drinks per week)   (Points: 1)

Background

HAS-BLED: acronym of the major factors associated with bleeding risk in patients with atrial fibrillation receiving oral anticoagulation.  Clinical Characteristics Composing the HAS-BLED Bleeding Risk Score Letter  Clinical  Characteristic Points Awarded H Hypertension 1 A Abnormal renal and liver function (1 point each) 1 or 2 S Stroke 1 B Bleeding 1 L Labile INRs 1 E Elderly 1 D Drugs or alcohol (1 point each) 1 or 2 Maximum possible score is 9 The risk of major bleeding within one year in atrial fibrillation patients enrolled in the Euro Heart Survey. HAS-BLED, acronym: Hypertension [uncontrolled, >160 mmHg systolic), Abnormal renal/liver function, Stroke, Bleeding history or predisposition [anemia], Labile INR [i.e. therapeutic time in range <60%], Elderly (>65) and Drugs/alcohol concomitantly [antiplatelet agents, non-steroidal anti-inflammatory drugs] [Maximum score 9]. HAS-BLED score n Bleeds, n Bleeds/100 patients* 0 798 9 1.13 1 1286 13 1.02 2 744 14 1.88 3 187 7 3.74 4 46 4 8.70 5 8 1 12.50 Any score 3071 48 1.56