HAS-BLED Bleeding risk tool

The HAS-BLED score is a clinical tool used to estimate the risk of bleeding in patients, particularly those with atrial fibrillation (AF) who are on anticoagulant therapy. The acronym HAS-BLED stands for:

· Hypertension

· Abnormal renal/liver function

· Stroke

· Bleeding history or predisposition

· Labile International Normalized Ratio (INR)

· Elderly (typically defined as age ≥65 years)

· Drugs or alcohol concomitantly

Understanding the risk of bleeding is essential for making informed decisions with patients. It helps in two ways: firstly, when the risk is low, it can reassure patients and encourage them to undergo anti-clotting treatments. Secondly, if the risk is high, it can lead to a conversation about how to minimize that risk.

Research indicates that the ORBIT tool is the most accurate for assessing bleeding risk in individuals with AF and it is the recommended tool by NICE. Nevertheless, while clinicians are getting familiar with ORBIT and integrating it into their systems, other tools like HAS-BLED, previously suggested by NICE, might still be in use.