HAS-BLED score for bleeding risk in anticoagulated atrial fibrillation
160 mm Hg)
<-- Abnormal renal function (chronic dialysis, renal transplantation, or serum creatinine ≥ 2.3 mg/dL)
<-- Cirrhosis or bilirubin > 2x normal, Alkaline phosphatase > 3x normal, liver transaminases > 3x normal
<-- Stroke
<-- Bleeding tendency/predisposition (history of bleeding or predisposition such as anemia)
<-- Labile INRs - if on warfarin - (history of over- anticoagulation or time in therapeutic range < 60%)
<-- Elderly (age > 65 y)
<-- Drugs (concomitant antiplatelet or nonsteroidal anti-inflammatory drugs)
<-- Alcohol intake in excess (> 8 drinks weekly)
Score --> numberscore1=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9) / 9 points
Result --> interpretatonscore2=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9);score2>5?'Major bleeding risk 12-15% per year - caution is warranted when prescribing oral anticoagulation and regular review is recommended':score2>4?'Major bleeding risk 9.1% per year - caution is warranted when prescribing oral anticoagulation and regular review is recommended':score2>3?'Major bleeding risk 8.9% per year - caution is warranted when prescribing oral anticoagulation and regular review is recommended':score2>2?'Major bleeding risk 5.8% per year - caution is warranted when prescribing oral anticoagulation and regular review is recommended':score2>1?'Major bleeding risk 4.1% per year':score2>0?'Major bleeding risk 3.4% per year':'Major bleeding risk 1% per year'
display/hide references
reference:
link Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010 Nov;138(5):1093-100

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