Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY.
"A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding
in atrial fibrillation patients: The Euro Heart Survey"
Chest. 2010 Nov;138(5):1093-100. doi: 10.1378/chest.10-0134. PMID: 20299623
This instrument is a therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation. It is matched to the CHA2DS2-VASc score used for stroke risk stratification.
HAS-BLED is an acronym of the major factors the system takes into account, using the first letter of each:
Hypertension - Abnormal kidney and/or liver function - Stroke - Bleeding - Labile INR - Elderly - Drugs and/or alcohol.
It has not been externally validated, but its use is recommended in some AFIB guidelines.
A score of 3 or more indicates increased one year bleed risk on anticoagulation sufficient to justify caution or more regular review. In the other hand, no studies have observed major bleeding in patients with score>5, showing that HAS-BLED bleeding risks should be interpreted with extreme caution.
Recent related article:
- → Lane DA, Lip GY. "Use of the CHA2DS2-VASc and HAS-BLED Scores to Aid Decision." Circulation. 2012 Aug 14;126(7):860-5.