HAS-BLED v.1
HAS-BLED bleeding risk score. Estimates risk of major bleeding for patients on anticoagulation for atrial fibrillation
To record HAS-BLED bleeding risk score
Hypertension is defined as systolic blood pressure >160 mmHg. Abnormal kidney function is defined as the presence of chronic dialysis or renal transplantation or serum creatinine 200 umol/L. Abnormal liver function is defined as chronic hepatic disease (e.g. cirrhosis) or biochemical evidence of significant hepatic derangement (e.g. bilirubin > 2 x upper limit of normal, in association with aspartate aminotransferase/alanine aminotransferase/alkaline phosphatase >3 x upper limit normal, etc.). Bleeding refers to previous bleeding history and/or predisposition to bleeding, e.g. bleeding diathesis, anaemia, etc. Labile INRs refers to unstable/high INRs or poor time in therapeutic range (e.g. <60%). Drugs/alcohol use refers to concomitant use of drugs, such as antiplatelet agents, non-steroidal anti-inflammatory drugs, or alcohol abuse, etc. INR (international normalized ratio). Adapted from Pisters et al.60 Individual scores are 0 for No or 1 for Yes with a maximum total score ranging between 0 and 9
Not to be used alone for absolute diagnostic purposes
Ref. 1: Pisters R, Lane DA, Nieuwlaat 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. Ref. 2: Lip GY, Frison L, Halperin JL, Lane DA. 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. J Am Coll Cardiol. 2011 Jan 11;57(2):173-80. doi: 10.1016/j.jacc.2010.09.024. Epub 2010 Nov 24.
OBSERVATION.blood_pressure.v2, OBSERVATION.lab_test_creatinine.v1, OBSERVATION.lab_test-bilirubin.v1, OBSERVATION.basic_demographic.v1, OBSERVATION.alcohol_use.v1, OBSERVATION.has_bled.v1, OBSERVATION.lab_test-alt.v1, OBSERVATION.lab_test-alp.v1, OBSERVATION.lab_test-ast.v1, EVALUATION.has_bled_assessment.v1
