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Cardiology

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HAS-BLED Score

Bleeding risk estimate in anticoagulated patients.

Consider using the HAS-BLED Score as a reference tool to assist in the shared decision-making discussion regarding anticoagulation in patients with atrial fibrillation. Consider comparing the risk for major bleeding as calculated by the HAS-BLED Score to the risk for thromboembolic events by the CHA2DS2-VASc to determine if the benefit of anticoagulation outweighs the risk.

Hypertension

Systolic blood pressure >160 mmHg. Not every patient with hypertension receives this point.

Abnormal renal function

Dialysis, kidney transplant, or serum creatinine >=200 micromol/L (approximately 2.26 mg/dL).

Abnormal liver function

Cirrhosis, or bilirubin >2x upper limit of normal plus AST/ALT/alkaline phosphatase >3x upper limit of normal.

Stroke history

Prior ischemic or hemorrhagic stroke. TIA is commonly included in many clinical implementations.

Bleeding history or predisposition

Previous major bleeding or predisposition to bleeding, such as significant gastrointestinal bleeding or intracranial hemorrhage.

Labile INR

Relevant only for patients treated with warfarin or acenocoumarol. Unstable/high INR values or time in therapeutic range <60%. For patients on DOACs, this point is usually not assigned.

Elderly

Age >65 years.

Drugs predisposing to bleeding

Concomitant nonsteroidal anti-inflammatory drugs (NSAIDs) or antiplatelet therapy.

Alcohol use

Excessive alcohol use - at least 8 units per week.

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Note: MedicalC is NOT medical software and does NOT issue diagnoses or treatment recommendations. The calculators are for educational and informational purposes, use published medical formulas, and are not a substitute for medical consultation. Results should be interpreted by professionals.Read the full disclaimer.