HAS-BLED Score

Estimates 1-year risk for major bleeding in atrial fibrillation to flag modifiable risk factors.

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Please use the manual scoring table below to calculate the score (Max 9 points).

Risk Factor

Points

Hypertension (uncontrolled, >160 mmHg systolic)

Abnormal Renal Function

Abnormal Liver Function

Stroke History

Bleeding History or Predisposition

Labile INRs (if on warfarin)

Elderly (> 65 years)

Drugs (antiplatelets/NSAIDs)

Alcohol Use (≥ 8 drinks/week)

Hypertension (uncontrolled, >160 mmHg systolic)

Abnormal Renal function (dialysis, transplant, Cr >2.26 mg/dL)

Abnormal Liver function (cirrhosis, bilirubin >2x normal, AST/ALT/AP >3x normal)

Stroke history

Bleeding history or predisposition

Labile INRs (if on warfarin, time in therapeutic range < 60%)

Elderly (age > 65 years)

Drugs (concomitant antiplatelets like aspirin, clopidogrel, or NSAIDs)

Alcohol use (≥ 8 drinks/week)

A high HAS-BLED score is NOT a reason to withhold oral anticoagulation (OAC) in patients with a high CHA₂DS₂-VASc score.

Instead, the score should be used to flag and correct modifiable bleeding risk factors, such as:

Score 0-2: Low to moderate bleeding risk.
Score ≥ 3: High bleeding risk. Indicates a need for regular clinical review and follow-up.