HAS-BLED Score

Major Bleeding Risk on Anticoagulation in Atrial Fibrillation

H — Hypertension Uncontrolled systolic BP >160 mmHg

A — Renal disease Dialysis, transplant, or Cr >2.26 mg/dL (200 µmol/L)

A — Liver disease Cirrhosis, or bilirubin >2× normal with AST/ALT/AP >3× normal

S — Stroke history Previous ischaemic or haemorrhagic stroke

B — Bleeding history or predisposition Prior major bleeding, anemia, or coagulopathy

L — Labile INR Unstable/high INRs, time in therapeutic range <60%

E — Elderly Age >65 years

D — Drugs predisposing to bleeding Antiplatelet agents (aspirin, clopidogrel) or NSAIDs

D — Alcohol use ≥8 drinks per week

HAS-BLED Score 0

Bleeds per 100 patient-years —

Low bleeding risk — no need to withhold anticoagulation

Score 0: 1.13 bleeds/100 patient-years — Low risk
Score 1: 1.02 bleeds/100 patient-years — Low risk
Score 2: 1.88 bleeds/100 patient-years — Moderate risk
Score ≥3: 3.74–12.5 bleeds/100 patient-years — High risk
Score ≥3 = "high risk" but does not automatically preclude anticoagulation — address modifiable risk factors.