HAS-BLED
Major bleeding risk on anticoagulation — read as a checklist, not a veto.
When to use it. Alongside CHA₂DS₂-VASc, to find and fix the bleeding risks that can be modified.
As informações de segurança médica desta página são apresentadas em inglês. Ainda não foram verificadas por um clínico que leia Português, e não é seguro confiar numa tradução que ninguém verificou.
0points
Low bleeding risk
Low bleeding risk (≥ 3 is conventionally called high). None of the points scored are modifiable, so the answer is closer follow-up, not withholding anticoagulation.
- Total score
- 0 / 9
- Modifiable points
- 0
One point each: uncontrolled hypertension · abnormal renal function · abnormal liver function · stroke · bleeding · labile INR · age > 65 · drugs · alcohol — maximum 9
Limits of this score. A high score is not a reason to withhold anticoagulation. Its value is that most of its components — uncontrolled blood pressure, labile INR, NSAIDs, alcohol — are things you can act on. Used as a veto, it withholds stroke prevention from exactly the people at highest stroke risk.
Sources
- Pisters R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation. Chest. 2010.
Where this is written from. This site is written from Indian clinical practice. Drug availability and brand names, vaccination schedules, national health programmes and some reference cut-offs differ between countries — a schedule or a threshold that is standard here may not be standard where you are. If you are reading outside India, check anything on this page against your own country’s guidance before you act on it.
Educational use only — not medical advice. Never a substitute for clinical judgement.