🩸 HAS‑BLED Score Calculator

Major bleeding risk assessment for atrial fibrillation patients on anticoagulation.
Used daily by cardiologists, hematologists, and primary care physicians. 100% client‑side, private.

🩸 Hypertension 🫀 Abnormal renal/liver 🧠 Stroke history 💊 Bleeding tendency 🔻 Labile INR

📋 Clinical context: Use HAS‑BLED alongside CHA₂DS₂‑VASc to guide anticoagulation decisions. Score ≥ 3 indicates high bleeding risk.

🩸 H – Hypertension

Uncontrolled systolic BP > 160 mmHg +1 point

🫀 A – Abnormal renal / liver function (1 point each, max 2)

Abnormal renal function (chronic dialysis, transplant, Cr > 2.26 mg/dL) +1 point

Abnormal liver function (cirrhosis, bilirubin > 2× ULN, AST/ALT > 3× ULN) +1 point

🧠 S – Stroke history

Prior stroke or TIA +1 point

💊 B – Bleeding history or predisposition

Prior major bleeding or predisposition (anemia, severe thrombocytopenia) +1 point

🔻 L – Labile INR

Unstable / high INRs (time in therapeutic range < 60%) +1 point

📅 E – Elderly (age > 65 years)

Age > 65 years +1 point

💊 D – Drugs or alcohol

Antiplatelet agent (aspirin, clopidogrel) +1 point

Alcohol use (≥ 8 drinks/week) +1 point

HAS‑BLED Score

—

📊 Annual Major Bleeding Risk (without anticoagulation adjustment)

—

🩺 Clinical Recommendation

—

🔍 Modifiable Risk Factors

—

📖 What is the HAS‑BLED Score?

The HAS‑BLED score was developed to estimate the 1‑year risk of major bleeding in patients with atrial fibrillation who are taking oral anticoagulation. It helps clinicians balance stroke prevention (CHA₂DS₂‑VASc) against bleeding risk.

Components (each 1 point except A = max 2):

H – Hypertension (uncontrolled SBP > 160)
A – Abnormal renal/liver function (1 point each)
S – Stroke history
B – Bleeding history or predisposition
L – Labile INR (TTR < 60%)
E – Elderly (> 65 years)
D – Drugs (antiplatelet) or alcohol use

✨ Clinical Utility & Interpretation

Score 0–2: Low bleeding risk. Anticoagulation is generally safe.
Score ≥ 3: High bleeding risk. Identify and address modifiable factors (BP control, INR stability, avoid NSAIDs/aspirin).

A high HAS‑BLED score does NOT necessarily preclude anticoagulation – instead, it flags patients who need closer monitoring and risk factor management.

💡 Pro tip: The HAS‑BLED score has been validated in multiple AF cohorts and predicts intracranial bleeding better than other tools.

⚠️ Important Considerations

HAS‑BLED is a dynamic score; re‑assess after addressing modifiable risks.
Patients with score ≥ 3 still benefit from anticoagulation if CHA₂DS₂‑VASc is high (shared decision‑making).
DOACs (direct oral anticoagulants) have lower bleeding risk than warfarin, especially intracranial hemorrhage.

❓ Frequently Asked Questions

Time in therapeutic range (TTR) < 60% or INR values that frequently exceed 4–5. It increases bleeding risk. DOACs avoid this issue.

No. High bleeding risk does not automatically rule out anticoagulation. Address modifiable factors (BP, INR control, alcohol) and consider DOACs. The net clinical benefit often still favors anticoagulation if stroke risk is high.

No. All calculations happen in your browser. No patient data is sent to any server.