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HAS-BLED Score Calculator

Score HAS-BLED bleeding risk on anticoagulation in atrial fibrillation. Toggle 9 factors for the total and 1-year major bleeding risk.

HAS-BLED Score Calculator

Adds 1 point (the elderly criterion) when older than 65.

Bleeding risk factors (1 point each)

Systolic blood pressure above 160 mmHg.

Dialysis, kidney transplant, or serum creatinine above 2.26 mg/dL (200 micromol/L).

Cirrhosis, or bilirubin above 2x the upper limit with AST, ALT, or ALP above 3x the upper limit.

Any history of stroke.

Prior major bleeding, a bleeding tendency, or anemia.

Unstable or high INR, or time in therapeutic range below 60% on a vitamin K antagonist (warfarin).

Concomitant aspirin, clopidogrel, or NSAID use.

Eight or more alcoholic drinks per week.

HAS-BLED score

1/ 9

Low to moderate bleeding risk

Major bleeding risk

1.02per 100 patient-years

Major bleeds per 100 patient-years (Pisters 2010)

Points by criterion

Hypertension

0 pts

Renal

0 pts

Liver

0 pts

Stroke

0 pts

Bleeding

0 pts

Labile INR

0 pts

Elderly > 65

1 pt

Drugs

0 pts

Alcohol

0 pts

Interpretation

Score 1. Low to moderate bleeding risk. Standard anticoagulation follow-up is reasonable. Re-check the score if hypertension control, kidney or liver function, INR stability, or medications change, since several HAS-BLED factors are modifiable.

Medical disclaimer

This tool is for educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. The HAS-BLED score estimates major bleeding risk on anticoagulation in atrial fibrillation; a high score is meant to flag modifiable risks and set follow-up, not to withhold anticoagulation by itself. Decisions about starting, continuing, or stopping an anticoagulant weigh bleeding risk against stroke risk (CHA2DS2-VASc), kidney and liver function, drug interactions, and patient preference, and belong with a qualified clinician who knows the full case.

Frequently Asked Questions about the HAS-BLED Score Calculator

What is the HAS-BLED score?
HAS-BLED estimates the risk of major bleeding in people with atrial fibrillation who take an anticoagulant. It was published by Pisters and colleagues in 2010 from the Euro Heart Survey. The acronym stands for Hypertension, Abnormal renal or liver function, Stroke, Bleeding history, Labile INR, Elderly (over 65), and Drugs or alcohol. You add one point for each factor that is present, for a maximum of 9.
How is each HAS-BLED point assigned?
You score one point each for uncontrolled hypertension (systolic above 160 mmHg), abnormal renal function, abnormal liver function, prior stroke, prior bleeding or a bleeding tendency, labile INR, age over 65, concomitant antiplatelet or NSAID drugs, and 8 or more alcoholic drinks per week. The two 'A' items (renal and liver) and the two 'D' items (drugs and alcohol) are counted separately, which is why the total can reach 9 even though the acronym has seven letters.
What does a HAS-BLED score of 3 or more mean?
A score of 3 or higher is considered high bleeding risk. It flags the need for caution and closer follow-up, and it is a prompt to correct modifiable risks such as uncontrolled blood pressure, NSAID or antiplatelet use, heavy alcohol intake, or an unstable INR. A high score is not, on its own, a reason to stop or withhold anticoagulation, because in atrial fibrillation the stroke reduction from anticoagulation usually outweighs the added bleeding risk.
How does HAS-BLED relate to CHA2DS2-VASc?
The two scores answer opposite questions for the same patient. CHA2DS2-VASc estimates the benefit of anticoagulation by predicting stroke risk, while HAS-BLED estimates the harm by predicting major bleeding. Clinicians weigh them together: a high HAS-BLED score rarely cancels a strong CHA2DS2-VASc indication, but it does sharpen the focus on reducing bleeding risk and on monitoring.
What is the major bleeding risk at each score?
In the original 2010 validation cohort the major bleeding rate per 100 patient-years was about 1.13 at a score of 0, 1.02 at 1, 1.88 at 2, 3.74 at 3, 8.70 at 4, and 12.50 at 5. The cohort had too few patients above a score of 5 to report a reliable rate, so this calculator shows the bleeding risk as not estimable for scores of 6 to 9 while still computing the total and the high-risk classification.
Is this calculator medical advice?
No. This tool is for education only and is not a substitute for professional medical advice, diagnosis, or treatment. The HAS-BLED score is one input into a clinical decision and never replaces a clinician's judgment, the full medical history, current lab values, or local protocols. Always discuss starting, continuing, or stopping any anticoagulant with a qualified healthcare professional.

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