HAS-BLED

Bleeding risk assessment in anticoagulated AF patients

Indication

id: htn; label: Uncontrolled hypertension (SBP >160); type: yesno; points: 1
id: renal; label: Abnormal renal function (dialysis, transplant, Cr >2.26); type: yesno; points: 1
id: liver; label: Abnormal liver function (cirrhosis, bilirubin >2x, AST/ALT >3x); type: yesno; points: 1
id: stroke; label: Prior stroke; type: yesno; points: 1
id: bleeding; label: Prior major bleeding or predisposition; type: yesno; points: 1
id: labile; label: Labile INR (TTR <60%); type: yesno; points: 1
id: elderly; label: Age > 65; type: yesno; points: 1
id: drugs; label: Drugs (antiplatelets, NSAIDs); type: yesno; points: 1
id: alcohol; label: Alcohol excess (≥8 drinks/week); type: yesno; points: 1

function(score) { if (score <= 2) return { risk: score + '/9', tier: 'Low-Moderate Risk', action: 'Acceptable bleeding risk. Proceed with anticoagulation if indicated.', color: 'green' }; return { risk: score + '/9', tier: 'High Bleeding Risk', action: 'Score ≥3: higher bleeding risk. Modify risk factors; does NOT mean withhold anticoagulation.', color: 'red' }; }

HAS-BLED ≥3 = high bleeding risk — but does NOT mean "don't anticoagulate"
Use to identify modifiable risk factors (HTN, drugs, alcohol, labile INR)
High HAS-BLED should trigger closer monitoring, not necessarily stopping anticoagulation
Balance against CHA₂DS₂-VASc — stroke risk usually outweighs bleeding risk