🩸 HAS-BLED Bleeding Risk Score
Estimate major bleeding risk on anticoagulation in atrial fibrillation with HAS-BLED.
Use to address reversible factors, not to withhold anticoagulation.
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When to use
Identify modifiable bleeding risk factors in AF anticoagulation decisions.
How it works
1 point each: hypertension, abnormal renal, abnormal liver, stroke, bleeding, labile INR, elderly (>65), drugs, alcohol. ≥ 3 = high risk.
Key points
- Use to address reversible factors, not to withhold anticoagulation.
- Weigh against stroke risk (CHA₂DS₂-VASc).
- Labile INR applies to warfarin (TTR < 60%).
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Uncontrolled hypertension (SBP > 160) | No |
|---|---|
| Abnormal renal function | No |
| Abnormal liver function | No |
| Stroke history | No |
| Prior major bleeding / predisposition | No |
| Labile INR (TTR < 60%) | No |
| Elderly (age > 65) | No |
| Drugs (antiplatelet/NSAID) | No |
| Alcohol ≥ 8 units/week | No |
→HAS-BLED0/9
- Interpretation：Lower bleeding risk.
| Uncontrolled hypertension (SBP > 160) | Yes |
|---|---|
| Abnormal renal function | Yes |
| Abnormal liver function | Yes |
| Stroke history | Yes |
| Prior major bleeding / predisposition | Yes |
| Labile INR (TTR < 60%) | Yes |
| Elderly (age > 65) | Yes |
| Drugs (antiplatelet/NSAID) | Yes |
| Alcohol ≥ 8 units/week | Yes |
→HAS-BLED9/9
- Interpretation：High bleeding risk — review modifiable factors, do not automatically withhold anticoagulation.
Frequently asked questions
- What is HAS-BLED Bleeding Risk Score?
- Estimate major bleeding risk on anticoagulation in atrial fibrillation with HAS-BLED.
- How is HAS-BLED Bleeding Risk Score calculated? What is the core formula?
- 1 point each: hypertension, abnormal renal, abnormal liver, stroke, bleeding, labile INR, elderly (>65), drugs, alcohol. ≥ 3 = high risk.
- When is HAS-BLED Bleeding Risk Score used?
- Identify modifiable bleeding risk factors in AF anticoagulation decisions.
- What are the key clinical points for HAS-BLED Bleeding Risk Score?
- Use to address reversible factors, not to withhold anticoagulation. Weigh against stroke risk (CHA₂DS₂-VASc). Labile INR applies to warfarin (TTR < 60%).
- What are the limits and cautions when using HAS-BLED Bleeding Risk Score?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is HAS-BLED Bleeding Risk Score calculated in practice? Can you show a worked example?
- Inputs: Uncontrolled hypertension (SBP > 160) No, Abnormal renal function No, Abnormal liver function No, Stroke history No, Prior major bleeding / predisposition No, Labile INR (TTR < 60%) No, Elderly (age > 65) No, Drugs (antiplatelet/NSAID) No… → Result: HAS-BLED 0 /9（Interpretation: Lower bleeding risk.） Inputs: Uncontrolled hypertension (SBP > 160) Yes, Abnormal renal function Yes, Abnormal liver function Yes, Stroke history Yes, Prior major bleeding / predisposition Yes, Labile INR (TTR < 60%) Yes, Elderly (age > 65) Yes, Drugs (antiplatelet/NSAID) Yes… → Result: HAS-BLED 9 /9（Interpretation: High bleeding risk — review modifiable factors, do not automatically withhold anticoagulation.）