HAS-BLED Score Calculator

HAS-BLED score for major bleeding risk on anticoagulation for AF.

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.
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Interpretation
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References

  1. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation. Chest. 2010;138(5):1093-1100.

What is HAS-BLED Score?

The HAS-BLED score estimates the one-year risk of major bleeding in patients with atrial fibrillation on oral anticoagulation. Derived by Pisters et al. in 2010 from the Euro Heart Survey, it allocates one point each to seven factors: Hypertension (uncontrolled), Abnormal renal or liver function, Stroke history, Bleeding history or predisposition, Labile INR, Elderly (>65), and Drugs (antiplatelets/NSAIDs) or alcohol — total 0–9. A score ≥3 indicates high bleeding risk (~3.7%/yr or more). It is meant to flag and correct modifiable risks, not to deny anticoagulation.

How to use

  1. Check each risk factor.
  2. The HAS-BLED score and bleeding risk category update instantly.
  3. Use to identify and address modifiable factors — not to withhold anticoagulation.

Frequently asked questions

What is HAS-BLED for?

It estimates 1-year risk of major bleeding in patients with atrial fibrillation on anticoagulation, identifying modifiable risk factors to address.

Should HAS-BLED ≥ 3 stop anticoagulation?

No. A high HAS-BLED is a flag to address modifiable risks (BP, alcohol, NSAIDs, labile INR), not a contraindication to anticoagulation.

HAS-BLED vs ATRIA vs ORBIT?

HAS-BLED remains the most widely used. ORBIT and ATRIA are alternatives with similar performance. ESC/AHA guidelines accept HAS-BLED for routine use.

Does HAS-BLED apply to DOACs?

It was derived in warfarin-treated patients but has been validated in DOAC users with similar predictive performance for major bleeding.

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