Scoring and risk stratification (part 2)

Last week, we went over the TIMI and CHADS2 scores. This week, The WeeklyMnemonic presents the HAS-BLED score which was specifically designed to estimate the risk of bleeding in patients with atrial fibrillation needing anti-coagulation. When a score of 3 or more is attained, caution should be taken when administering anti-coagulation.

H = Hypertension (systolic >160 mmHg)

A = Abnormal liver or renal function [1 point each for a max of 2 points for this criteria]

S = Stroke

B = Bleeding (previous bleed or known predisposition)

L = Labile INR (therapeutic less than 60% of the time)

E = Elderly (age >65)

D = Drugs (i.e. concomitantly on antiplatelets or NSAIDS) and Drinks (i.e. alcohol excess) [1 point each for a max of 2 points for this criteria]

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