# HAS-BLED Calculator (Bleeding Risk)

URL: https://speedycalculator.com/calculators/health/has-bled/
Last updated: 2026-10-30

> The HAS-BLED calculator estimates the one-year risk of major bleeding in patients with atrial fibrillation taking anticoagulants, from nine risk factors, and flags those who need closer review.

## Inputs

- Hypertension (uncontrolled, systolic > 160 mmHg)
- Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL)
- Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal)
- Previous stroke
- Previous major bleeding or predisposition
- Labile INR (time in range < 60%)
- Elderly (age over 65)
- Medication predisposing to bleeding (antiplatelets, NSAIDs)
- Alcohol use (8 or more drinks a week)

## Results

- HAS-BLED score
- Major bleeds per 100 patient-years
- Bleeding risk

## Formula

```
Score = sum of the points for each item
```

## Explanation

HAS-BLED helps identify modifiable bleeding risks – uncontrolled blood pressure, labile INR, alcohol and drugs such as NSAIDs – rather than deciding against anticoagulation. A score of 3 or more indicates high bleeding risk and calls for more frequent review.

### How to use the HAS-BLED Calculator

- **Hypertension (uncontrolled, systolic > 160 mmHg)**
- **Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL)**
- **Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal)**
- **Previous stroke**
- **Previous major bleeding or predisposition**
- **Labile INR (time in range < 60%)**
- **Elderly (age over 65)**
- **Medication predisposing to bleeding (antiplatelets, NSAIDs)**
- **Alcohol use (8 or more drinks a week)**

Results update as you type, and every field accepts the units shown in its menu.

### How it works

Each answer carries the points shown in the published score. The calculator adds them up and maps the total to the published interpretation.

### Scoring table

ItemAnswers and pointsHypertension (uncontrolled, systolic > 160 mmHg)No = 0; Yes = 1Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL)No = 0; Yes = 1Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal)No = 0; Yes = 1Previous strokeNo = 0; Yes = 1Previous major bleeding or predispositionNo = 0; Yes = 1Labile INR (time in range < 60%)No = 0; Yes = 1Elderly (age over 65)No = 0; Yes = 1Medication predisposing to bleeding (antiplatelets, NSAIDs)No = 0; Yes = 1Alcohol use (8 or more drinks a week)No = 0; Yes = 1

### Bleeding risk by score

ScoreMajor bleeds per 100 patient-years01.1311.0221.8833.7448.7512.55 or more12.5 or more

### Inputs explained

FieldWhat to enterHypertension (uncontrolled, systolic > 160 mmHg)Choose one: No, YesAbnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL)Choose one: No, YesAbnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal)Choose one: No, YesPrevious strokeChoose one: No, YesPrevious major bleeding or predispositionChoose one: No, YesLabile INR (time in range < 60%)Choose one: No, YesElderly (age over 65)Choose one: No, YesMedication predisposing to bleeding (antiplatelets, NSAIDs)Choose one: No, YesAlcohol use (8 or more drinks a week)Choose one: No, Yes

### What each result means

- **HAS-BLED score** = [Hypertension (uncontrolled, systolic > 160 mmHg)] + [Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg÷dL)] + [Abnormal liver function (cirrhosis or bilirubin > 2× ÷ AST÷ALT > 3× normal)] + [Previous stroke] + [Previous major bleeding or predisposition] + [Labile INR (time in range < 60%)] + [Elderly (age over 65)] + [Medication predisposing to bleeding (antiplatelets, NSAIDs)] + [Alcohol use (8 or more drinks a week)]
- **Major bleeds per 100 patient-years** = interp([HAS-BLED score], 0, 1, 1.13, 1.02, 1.88, 3.74, 8.7, 12.5)

*Health note: this calculator is for education and screening only and is not a diagnosis or treatment advice. Discuss your results with a qualified clinician.*

## Worked example

Inputs — Hypertension (uncontrolled, systolic > 160 mmHg): No; Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL): No; Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal): No; Previous stroke: No; Previous major bleeding or predisposition: No; Labile INR (time in range < 60%): No; Elderly (age over 65): Yes; Medication predisposing to bleeding (antiplatelets, NSAIDs): No; Alcohol use (8 or more drinks a week): No.

Results — **HAS-BLED score = 1 / 9**; Major bleeds per 100 patient-years = 1.02; Bleeding risk = Low to moderate.

## Key terms

- **INR**: International normalised ratio.
- **DOAC**: Direct oral anticoagulant.

## FAQ

**Does a high HAS-BLED score mean I should stop anticoagulation?**
Not by itself – it means bleeding risks should be addressed and monitored.

**What can lower my bleeding risk?**
Controlling blood pressure, avoiding NSAIDs and alcohol excess, and stable INR or switching to a DOAC.

**Is HAS-BLED used for DOACs?**
Yes; the labile INR item applies only to warfarin.


## Sources

- [Pisters R et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in AF. Chest, 2010](https://pubmed.ncbi.nlm.nih.gov/20299623/)