| Letter | Risk | Points | HAS-BLED Score | Bleeds per 100 Patient-Years |
|---|---|---|---|---|
| H | Hypertension (uncontrolled, systolic blood pressure >160 mmHg) | 1 | 0 | 1.13 |
| A | Abnormal ± renal function* Abnormal liver function† | 1 or 2 | 1 | 1.02 |
| S | Stroke history | 1 | 2 | 1.88 |
| B | Bleeding (major bleed: anemia or predisposition to bleed) | 1 | 3 | 3.74 |
| L | Labile INRs (time in therapeutic range <60%) | 1 | 4 | 8.7 |
| E | Elderly (age >65 years) | 1 | 5–9 | Insufficient data‡ |
| D | Drugs or alcohol (antiplatelets or NSAIDs, or excess alcohol§) | 1 or 2 | — | — |
↵* Abnormal renal function is classified as the presence of chronic dialysis, renal transplantation, or serum creatinine ≥200 μmol/L (2.26 mg/dL).
↵† Abnormal liver function is defined as chronic hepatic disease (eg, cirrhosis) or biochemical evidence of significant hepatic derangement (bilirubin 2 to 3 times the upper limit of normal, in association with aspartate aminotransferase/alanine aminotransferase raise/alkaline phosphatase 3 times the upper limit of normal).
↵‡ Insufficient events at HAS-BLED scores of >5 in initial validation cohort.
↵§ Excess alcohol is defined as the consumption of ≥8 alcoholic units/wk.
Reproduced with permission from Lip.11
INR, international normalized ratio; NSAID, nonsteroidal anti-inflammatory agent.