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==Overview==
==Overview==
A [[therapeutic bleeding risk]] stratification score for those on oral anticoagulants in [[atrial fibrillation]]<ref>[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=20299623  Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest. 2010 Mar 18.]<small>(Epub ahead of print) </small><small>([http://dx.doi.org/10.1378/chest.10-0134 Link to article] &ndash; subscription may be required.)</small></ref>. It is matched to the [[CHA2DS2-VASc score]] used for stroke risk stratification but has not as of [[2010]] been externally validated.
A [[therapeutic bleeding risk]] stratification score for those on oral anticoagulants in [[atrial fibrillation]]<ref>[http://www.ncbi.nlm.nih.gov/sites/entrez?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=20299623  Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest. 2010 Mar 18.]<small>(Epub ahead of print) </small><small>([http://dx.doi.org/10.1378/chest.10-0134 Link to article] &ndash; subscription may be required.)</small></ref>. It is matched to the [[CHA2DS2-VASc score]] used for stroke risk stratification. In a recent article validating the score, diabetes and left ventricular dysfunction were identified as additional risk factors for bleeding<ref name="pmid21111555">{{cite journal |author=Lip GY, Frison L, Halperin JL, Lane DA |title=Comparative Validation of a Novel Risk Score for Predicting Bleeding Risk in Anticoagulated Patients With Atrial Fibrillation The HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) Score |journal=[[Journal of the American College of Cardiology]] |volume=57 |issue=2 |pages=173–80 |year=2011 |month=January |pmid=21111555 |doi=10.1016/j.jacc.2010.09.024 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(10)04337-8 |issn= |accessdate=2011-01-24}}</ref>.


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Revision as of 13:52, 24 January 2011

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Editors-in-Chief: Gregory Lip, MD [1] and C. Michael Gibson, M.S., M.D. [2]

Overview

A therapeutic bleeding risk stratification score for those on oral anticoagulants in atrial fibrillation[1]. It is matched to the CHA2DS2-VASc score used for stroke risk stratification. In a recent article validating the score, diabetes and left ventricular dysfunction were identified as additional risk factors for bleeding[2].

HAS-BLED score for bleeding risk on oral anticoagulation in atrial fibrillation
Feature Score if present
Hypertension (Systolic ≥ 160mmHg) 1
Abnormal renal function 1
Abnormal liver function 1
Age ≥ 65 years 1
Stroke in past 1
Bleeding 1
Labile INRs 1
Taking other drugs as well 1
Alcohol intake at same time 1

Interpretation of the HAS-BLED Score

A score of 3 or more indicates an increased one year bleed risk on anticoagulation which would be sufficient to justify caution or more frequent evaluation. The risk is the risk of an intracranial bleed, bleeding requiring hospitalization or a hemoglobin drop > 2g/L or a bleeding episode that requires transfusion.

  1. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess one-year risk of major bleeding in atrial fibrillation patients: The Euro Heart Survey. Chest. 2010 Mar 18.(Epub ahead of print) (Link to article – subscription may be required.)
  2. Lip GY, Frison L, Halperin JL, Lane DA (2011). "Comparative Validation of a Novel Risk Score for Predicting Bleeding Risk in Anticoagulated Patients With Atrial Fibrillation The HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) Score". Journal of the American College of Cardiology. 57 (2): 173–80. doi:10.1016/j.jacc.2010.09.024. PMID 21111555. Retrieved 2011-01-24. Unknown parameter |month= ignored (help)