Table 2. Assessment of Bleeding Risk (HAS-BLED) in Patients With Atrial Fibrillation
LetterRiskPointsHAS-BLED ScoreBleeds per 100 Patient-Years
HHypertension (uncontrolled, systolic blood pressure >160 mmHg)101.13
AAbnormal ± renal function*
Abnormal liver function
1 or 211.02
SStroke history121.88
BBleeding (major bleed: anemia or predisposition to bleed)133.74
LLabile INRs (time in therapeutic range <60%)148.7
EElderly (age >65 years)15–9Insufficient data
DDrugs 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.