Medical Minute: HAS-BLED score

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August 21, 2014 by dailybolusoflr

By: Julie Rice, MD

Calculate a HAS-BLED score with a CHADS2 score ( to determine if the risk of bleeding outweighs the benefit of anticoagulation in Atrial fibrillation and Atrial flutter patients when considering vitamin K antagonists.

For example, if the CHADS2 score is 3 then a HAS-BLED score of three or more is predictive of harm > benefit for anticoagulation.

Use is recommended by Canadian Cardiovascular Society, but not the ACC/AHA

Original derivation from European Heart Survey data with a prospective cohort of 4,000 patients with AF who were followed for one year to determine risk of major bleed (53 pts total had major bleed)

Pisters, et al.  A Novel User-Friendly Score (HAS-BLED) To Assess 1-Year Risk of Major Bleeding in Patients With Atrial Fibrillation.  CHEST 2010

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