HAS-BLED Score Calculator

Assess major bleeding risk in patients with atrial fibrillation on anticoagulation.

HAS-BLED Criteria

Select all criteria that apply:

Hypertension (uncontrolled, SBP >160 mmHg)

Abnormal renal function (dialysis, transplant, Cr >2.26 mg/dL)

Abnormal liver function (cirrhosis, bilirubin >2x normal, AST/ALT/ALP >3x normal)

Stroke history

Bleeding history or predisposition

Labile INR (unstable/high INRs, TTR <60%)

Elderly (age >65)

Drugs predisposing to bleeding (antiplatelets, NSAIDs)

Alcohol use (≥8 drinks/week)

HAS-BLED Score

0/9

Low Risk

Major Bleeding Risk: 0.9%/year

Risk Level

Low Risk

Annual Risk

0.9%

Clinical Recommendation

Low bleeding risk. Anticoagulation generally safe. Standard monitoring.

Score Interpretation

0-1: Low risk (0.9-3.4%/year)
2: Moderate risk (4.1%/year)
≥3: High risk (>5.8%/year)

Modifiable Risk Factors

- Hypertension - optimize BP control
- Labile INR - improve TTR or switch to DOAC
- Drugs - minimize NSAIDs/antiplatelets
- Alcohol - reduce consumption

Important Note

HAS-BLED ≥3 does not mean anticoagulation is contraindicated. It identifies patients needing closer monitoring and risk factor modification. Always balance against stroke risk (CHA₂DS₂-VASc).