Calculate the HAS-BLED score to estimate major bleeding risk in patients on oral anticoagulation (most commonly combined with CHA₂DS₂-VASc in atrial fibrillation). Each component scores 1 point: Hypertension (uncontrolled, systolic BP >160), Abnormal renal function (dialysis/transplant/Cr >2.26 mg/dL), Abnormal liver function, prior Stroke, prior major Bleeding/predisposition, Labile INR (TTR <60% on warfarin), Elderly (age >65), Drugs (antiplatelet/NSAID), Alcohol (≥8 drinks/week). Range 0–9 (renal/liver and drugs/alcohol can each contribute up to 2). Interpretation: 0 low, 1–2 moderate, ≥3 high risk — regular review and correct reversible factors; a high score alone does NOT justify withholding anticoagulation. Derived from Pisters 2010 (Chest) and the 2023 ACC/AHA/ACCP/HRS AF guideline. The 'labile INR' criterion mainly applies to warfarin users; predictive value is lower for DOACs. Not medical advice.
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Key facts
Category
Health
Input types
checkbox
Output type
json
Sample coverage
4
API ready
Yes
Overview
The HAS-BLED Score calculator estimates major bleeding risk in patients taking oral anticoagulants. Select the applicable clinical factors to calculate a score from 0 to 9 and view the corresponding risk category: low, moderate, or high.
When to use
Assess bleeding risk in a patient receiving oral anticoagulation, especially for atrial fibrillation.
Review modifiable bleeding risk factors such as uncontrolled hypertension, NSAID use, or excess alcohol intake.
Support a broader anticoagulation review alongside stroke-risk assessment and clinical judgment.
How it works
1Select each applicable HAS-BLED factor, including hypertension, renal or liver dysfunction, prior stroke, bleeding history, labile INR, age over 65, drugs, and alcohol.
2The calculator assigns points to the selected factors and adds them to produce the total score.
3The result categorizes the score as low, moderate, or high bleeding risk.
4Use the result to identify factors for review; a high score alone does not justify withholding anticoagulation.
Use cases
Cardiology and atrial fibrillation reviews where bleeding risk is considered alongside CHA₂DS₂-VASc.
The calculator returns a total score of 4, categorized as high risk (≥3), supporting review of blood pressure, INR stability, and NSAID use.
2. Single risk factor in an older anticoagulated patient
Primary care clinician
Background
A patient receiving oral anticoagulation is over 65 but has no reported hypertension, renal or liver dysfunction, prior stroke, bleeding history, labile INR, relevant drugs, or excess alcohol use.
Problem
Calculate the score when age is the only selected HAS-BLED factor.
FAQ
What does the HAS-BLED Score measure?
It estimates the risk of major bleeding in patients taking oral anticoagulants.
What is the HAS-BLED score range?
The score ranges from 0 to 9.
How is the HAS-BLED score interpreted?
A score of 0 is low risk, 1–2 is moderate risk, and 3 or higher is high risk.
Does a high HAS-BLED score mean anticoagulation should be stopped?
No. A high score calls for regular review and correction of reversible factors, but does not by itself justify stopping anticoagulation.
Does the labile INR criterion apply to DOAC users?
It mainly applies to patients taking warfarin; its predictive value is lower for DOACs.