Clinical tool
HAS-BLED
Bleeding risk in patients on anticoagulation.
HAS-BLED
0/ 9
Lower bleeding risk
Score of 0 or 1. Continue routine review of modifiable bleeding factors.
This score supports risk stratification and should be interpreted alongside the overall clinical context and current treatment guidance.
Score support, not a decision
What this calculates
Bleeding risk on anticoagulation: nine items worth one point each, from 0 to 9.
When to use it
When starting or reviewing anticoagulation, to find modifiable bleeding risk factors.
How to interpret it
A score of 3 or more flags higher risk and a need for closer review. Many items are modifiable, such as blood pressure, NSAIDs, alcohol and INR control.
Important limitations
- A high score is not on its own a reason to withhold anticoagulation.
- The labile INR item applies only to patients taking warfarin.
- Discrimination is modest. It should be used with clinical judgement and the patient's stroke risk.
For practising medics only. Clinical tools support judgement, they do not replace it. Always verify results against current guidelines and the patient in front of you.