HAS-BLED Score = 0

Risk assessment for hemorrhage in patients with atrial fibrillation on anticoagulation.

* Liver dysfunction is defined as either (1) chronic or (2) AST/ALT/AP > 3x upper limit of normal with bilirubin > 2x upper limit of normal.

Clopidogrel and other antiplatelet agents were excluded from initial trials of HAS-BLED.

c-index is about 0.6-0.72 for prediction of major bleeding.

Trials have varied in bleeding rates, which may be due to variability of % patients on warfarin.

Pisters R et al. 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; 138(5):1093-1100. Text

Camm AJ et al. Guidelines for the management of atrial brillation. The task force for the management of atrial brillation of the European Society of Cardiology (ESC). Eur Heart J. 2010; 31(19):2369-2429.

Lip GYH et al. Bleeding risk assessment and management in atrial brillation patients: a position document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis. Europace. 2011; 13.

Apostolakis, S et al. Performance of the HEMORR2HAGES, ATRIA, and HAS-BLED Bleeding Risk–Prediction Scores in Patients With Atrial Fibrillation Undergoing Anticoagulation. J Am Coll Card. 2012; 60(9): 861-7.