HAS-BLED: HAS-BLED Score for Major Bleeding Risk

1-year risk of major bleeding on oral anticoagulation. Free to use.

cardiology 9 items Updated 2026-05-05

Score HAS-BLED below → Download printable PDF View source paper (DOI)
What is HAS-BLED? HAS-BLED (HAS-BLED Score for Major Bleeding Risk) is a validated instrument used to assess 1-year risk of major bleeding on oral anticoagulation. It comprises 9 items.

What is HAS-BLED?

HAS-BLED (HAS-BLED Score for Major Bleeding Risk) is a validated clinical instrument used to assess 1-year risk of major bleeding on oral anticoagulation. The instrument contains 9 items.

Source / attribution: Pisters R et al., Chest 2010

Clinical context: when HAS-BLED is used

Like all screening or assessment instruments, HAS-BLED is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.

Score HAS-BLED

Answer all 9 items below to see your HAS-BLED score and interpretation.

All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.

How HAS-BLED is scored

HAS-BLED uses weighted summation: each item carries a fixed weight that is added when the response indicates a positive finding.

Scoring notes: Educational use only. Not a substitute for clinical judgment.

HAS-BLED score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–2Low riskLow bleeding risk.
3–9High riskHigher bleeding risk — review carefully.

How to score HAS-BLED: a step-by-step worked example

This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.

Step 1 — Score each item

Mark each item Yes or No. Each "Yes" adds the item's weight; each "No" adds 0. The example below uses illustrative answers.

#ItemExample responseScore
1Hypertension (uncontrolled, SBP > 160)Yes1
2Abnormal renal function (Cr > 2.26 mg/dL or dialysis)Yes1
3Abnormal liver function (cirrhosis, bilirubin > 2x ULN with AST/ALT > 3x ULN)Yes1
4Prior strokeYes1
5Prior major bleeding or predispositionNo0
6Labile INR (TTR < 60%)Yes1
7Elderly (age > 65)No0
8Drugs predisposing to bleeding (antiplatelets, NSAIDs)Yes1
9Alcohol use ≥ 8 drinks/weekNo0

Step 2 — Add up the scores

Add the weights from the items where you marked "Yes" (skip the "No" answers — they contribute 0).

1 + 1 + 1 + 1 + 0 + 1 + 0 + 1 + 0 = 6

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 6 falls between 3 and 9High risk

Step 4 — What does this mean clinically?

High risk. Caution and regular review of anticoagulation indicated.

A score is one input alongside history and examination. HAS-BLED supports clinical judgment — it does not replace it.

Score HAS-BLED with your own answers above →

Limitations & common pitfalls

How HAS-BLED compares to other cardiology scales

If HAS-BLED doesn't fit your context, related instruments in cardiology include:

ScaleMeasuresItemsTime
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8
HEART Score6-week MACE risk in ED patients with chest pain5
NYHA Functional ClassFunctional capacity in heart failure1
APGAR ScoreRapid assessment of newborn at 1 and 5 min5
ASA Physical StatusPre-operative health status1
CURB-6530-day mortality in community-acquired pneumonia5
Glasgow Coma ScaleLevel of consciousness after head injury3
Katz ADLFunctional independence in basic ADLs6

Frequently asked questions about HAS-BLED

What does HAS-BLED measure?

HAS-BLED (HAS-BLED Score for Major Bleeding Risk) is a validated instrument that assesses 1-year risk of major bleeding on oral anticoagulation.

How many items are on HAS-BLED?

HAS-BLED contains 9 items.

What is a high HAS-BLED score?

Scores of 3–9 fall in the "High risk" band. Higher bleeding risk — review carefully.

What is a low HAS-BLED score?

Scores of 0–2 fall in the "Low risk" band. Low bleeding risk.

Is HAS-BLED free to use?

Yes — HAS-BLED is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for HAS-BLED?

Pisters R et al. Chest. 2010;138(5):1093-1100.

Can HAS-BLED replace clinical judgment?

No. HAS-BLED is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

HAS-BLED is supported by the following peer-reviewed sources: