HAS-BLED Score for Major Bleeding Risk

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The HAS-BLED Score for Major Bleeding Risk calculates the bleeding risk for patients with atrial fibrillation.

Research authors: Ron Pisters, Deirdre A. Lane, Robby Nieuwlaat, Cees B. de Vos, Harry J.G.M. Crijns, Gregory Y.H. Lip

Version: 3.22

Public
Cardiology
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V-3.22-162.24.05.31

(01)08720299526426(8012)v3.22(4326)240531(240)162

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The HAS-BLED score is a simple and practical tool to assess the bleeding risk in patients with atrial fibrillation. Even though the tool may support decision involving the initiation of anticoagulant treatment, a high bleeding risk alone should not immediately lead to withholding anticoagulation.

The HAS-BLED score has been validated and compared with other similar tools. On discrimination, the HAS-BLED performs poorly to moderately (C-index 0.58 - 0.72).

The HAS-BLED tool can be used together with tools to predict stroke risk and or together with other bleeding risk assessment tools.

Out of the 3071 patients used to develop the HAS-BLED score, a total of 48 patients suffered from bleeding, corresponding to 1.56 bleeds per 100 patient-years.

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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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Model author

Evidencio.Medical.Devices

Model ID

10435

Version

3.22

Revision date

2024-05-31

Specialty

Cardiology

Model type

Linear model ^{(Calculation)}

MeSH terms

Bleeding

Anticoagulants

Atrial Fibrillation

Status

Public

Formula
No Formula defined yet

Condition	Formula

Study characteristics

Additional information

Study included 5,333 ambulatory and hospitalized patients with AF from both academic and non-academic hospitals in 35 member countries of the European Society for Cardiology. Patients were followed up at one year to determine survival and major adverse cardiovascular events, such as major bleeding. Major bleeding defined as any bleeding requiring hospitalization, and/or causing a decrease in hemoglobin level > 2 g/L, and/or requiring blood transfusion that was not hemorrhagic stroke. Researchers performed a retrospective, univariate analysis to find potential bleeding risk factors when comparing the groups with and without major bleeding at 1 year follow-up. Developed HAS-BLED score based on results of their analysis as well as known significant risk factors for major bleeding.

Of the 5,272 patients with AF in the Euro Heart Survey of AF who were discharged alive, 3,456 (66%) patients without mitral valve stenosis or valvular surgery had 1-year follow-up status regarding major bleeding.

Study Population

Total population size: 3456

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Continuous characteristics

Name	Mean	SD	Unit
Age	66.8	12.8	years

Categorical characteristics

Name	Subset / Group	Nr. of patients
Bleeding	Bleed	53
Bleeding	No bleed	3910

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V-3.22-162.24.05.31

Medical Devices

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Study characteristics

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Study Population

Continuous characteristics

Categorical characteristics

Supporting Publications

Related files

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	Evidencio B.V., Irenesingel 19, 7481 GJ Haaksbergen, The Netherlands
	V-3.22-162.24.05.31
	(01)08720299526426(8012)v3.22(4326)240531(240)162
	Decomplix AG, Freiburgstrasse 3, 3010 Bern, Switzerland
	Download the User manual
	Medical device