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
| Item | Answers and points |
|---|---|
| Hypertension (uncontrolled, systolic > 160 mmHg) | No = 0; Yes = 1 |
| Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL) | No = 0; Yes = 1 |
| Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal) | No = 0; Yes = 1 |
| Previous stroke | No = 0; Yes = 1 |
| Previous major bleeding or predisposition | No = 0; Yes = 1 |
| Labile INR (time in range < 60%) | No = 0; Yes = 1 |
| Elderly (age over 65) | No = 0; Yes = 1 |
| Medication predisposing to bleeding (antiplatelets, NSAIDs) | No = 0; Yes = 1 |
| Alcohol use (8 or more drinks a week) | No = 0; Yes = 1 |
Bleeding risk by score
| Score | Major bleeds per 100 patient-years |
|---|---|
| 0 | 1.13 |
| 1 | 1.02 |
| 2 | 1.88 |
| 3 | 3.74 |
| 4 | 8.7 |
| 5 | 12.5 |
| 5 or more | 12.5 or more |
Inputs explained
| Field | What to enter |
|---|---|
| Hypertension (uncontrolled, systolic > 160 mmHg) | Choose one: No, Yes |
| Abnormal renal function (dialysis, transplant, creatinine > 2.26 mg/dL) | Choose one: No, Yes |
| Abnormal liver function (cirrhosis or bilirubin > 2× / AST/ALT > 3× normal) | Choose one: No, Yes |
| Previous stroke | Choose one: No, Yes |
| Previous major bleeding or predisposition | Choose one: No, Yes |
| Labile INR (time in range < 60%) | Choose one: No, Yes |
| Elderly (age over 65) | Choose one: No, Yes |
| Medication predisposing to bleeding (antiplatelets, NSAIDs) | Choose one: No, Yes |
| Alcohol 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.
Formula
Score = sum of the points for each item
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.
Frequently asked questions
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.