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HAS-BLED bleeding risk score

Also called HASBLED, AF bleeding risk

One-year major bleeding risk in anticoagulated atrial fibrillation; flags modifiable risk factors.

HAS-BLED

0/9

Bleeding risk
Not high (0–2)

Bleeding risk is not high on this score; still address any modifiable factor.

Formula and scoring

H, A (renal 1 + liver 1), S, B, L, E, D (drugs 1 + alcohol 1). Maximum 9; ≥3 = high risk.

Exam and ward pearls

  • Labile INR applies only to VKA users; score it 0 on a DOAC.
  • HAS-BLED is meant to find fixable bleeding risks, not to deny anticoagulation.

When not to rely on it

  • Derived in the Euro Heart Survey (n = 3,978); discrimination is modest (C statistic about 0.72).

Source

  1. Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093-100. doi:10.1378/chest.10-0134 · PMID 20299623
  2. Chao TF, Potpara TS, Lip GYH. Atrial fibrillation: stroke prevention. Lancet Reg Health Eur. 2024;37:100797. (Table 1 reproduces CHA2DS2-VASc and HAS-BLED as in the 2020 ESC AF guideline.) doi:10.1016/j.lanepe.2023.100797 · PMID 38362551

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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