HAS-BLED for Assessing Bleeding Risk with Anticoagulation: Best of the Mediocre

Notwithstanding a lackluster performance, HAS-BLED beat two other scoring systems in a comparative analysis of trial data.

Bleeding continues to be the Achilles heel of systemic anticoagulation, whether the agent used is warfarin or any of the new anticoagulants entering the market. Predictive models for bleeding include the following:

HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol)
HEMORR2HAGES (hepatic or renal disease, ethanol abuse, malignancy, elderly, reduced platelet count or function, rebleeding, hypertension, anemia, genetic factors, excessive fall risk, stroke)

ATRIA (anticoagulation and risk factors in atrial fibrillation)

Investigators for the AMADEUS trial comparing warfarin with idraparinux (JW Gen Med Feb 26 2008) retrospectively applied …

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

HAS-BLED for Assessing Bleeding Risk with Anticoagulation: Best of the Mediocre

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Reviewing Author