HAS-BLED Bleeding Risk Calculator
HAS-BLED estimates 1-year major bleeding risk in patients on anticoagulation for atrial fibrillation. Use alongside CHA₂DS₂-VASc to weigh stroke vs bleeding risk.
HAS-BLED Score
Interpretation (annual major bleeding risk)
- 0–1: Low risk (~1%)
- 2: Moderate (~2%)
- ≥3: High (~5%+) — closer monitoring needed, address modifiable factors
Source: Pisters R et al. A novel user-friendly score (HAS-BLED). Chest. 2010;138(5):1093-100.
Frequently asked questions
Does a high HAS-BLED rule out anticoagulation?
No. Most patients with high HAS-BLED still benefit from anticoagulation if their CHA₂DS₂-VASc is also high. The score identifies modifiable risk factors — controlling BP, limiting alcohol, avoiding NSAIDs reduces bleeding risk.
How is HAS-BLED used clinically?
Alongside CHA₂DS₂-VASc to weigh stroke vs bleeding risk. Together they support shared decision-making about anticoagulation in atrial fibrillation.
What is labile INR?
Time-in-therapeutic-range less than 60% on warfarin. Not applicable to DOAC users.
Should I worry about a HAS-BLED of 4?
It indicates higher bleeding risk requiring closer monitoring and modifiable-factor optimization. It rarely justifies stopping anticoagulation outright when stroke risk is significant.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.