⚕️ For clinical reference only. Not a substitute for professional judgment.

HAS-BLED Score Bleeding Risk

Bleeding risk score for patients on anticoagulation. High score = address modifiable factors, not withhold anticoagulation.

0/9

Low Bleeding Risk

Select risk factors present.

HAS-BLED Criteria

H — Uncontrolled hypertension (SBP >160 mmHg)+1 A — Abnormal renal function (dialysis, transplant, creatinine >200 µmol/L)+1 A — Abnormal liver function (cirrhosis, bilirubin >2×ULN + ALT/AST >3×ULN)+1 S — Prior stroke history+1 B — Prior bleeding or bleeding predisposition+1 L — Labile INR (if on warfarin, time in therapeutic range <60%)+1 E — Elderly (age >65 years)+1 D — Drugs (antiplatelets, NSAIDs)+1 D — Alcohol (≥8 units/week)+1

Interpretation

0–1 = Low risk (~1–2%/yr) → Anticoagulate
2 = Moderate (~3%/yr) → Regular review
≥3 = High (~4–8%/yr) → Address correctable factors;
do NOT automatically withhold anticoagulation

⚠️ High HAS-BLED is not a reason to avoid anticoagulation — it is a flag to correct modifiable risk factors.

References

Pisters R et al. Chest. 2010.
ESC Guidelines for AF. 2020.
NICE NG196 — Atrial fibrillation. 2021.