- The HAS-BLED tool is often used to assess a patient’s bleeding risk before starting the use of anticoagulation – particularly in relation to atrial fibrillation.
- It is often used in conjunction with the CHA2DS2-VASc score to weigh the risks and benefits of anticoagulation.
- Each item is worth a single point
- A score of ≥3 indicates “high risk” for bleeding if anticoagulation is used and it is recommended to either very closely follow-up the patient or consider alternatives to anticoagulation
| H | Hypertension >160mmHg systolic |
| A | Abnormal renal or liver function |
| S | Previous history of stroke |
| B | Previous history of major bleeding |
| L | Labile INR |
| E | IV drug use (<60% of time in therapeutic range) |
| D | Drug and alcohol use – NSAIDs, anti-platelet agents, alcohol >8 weeks / week |