PUBLIC LIBRARY / CALCULATOR

HAS-BLED

Estimates 1-year major bleeding risk in anticoagulated atrial fibrillation patients and identifies correctable factors.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

HAS-BLED/Pisters 2010: 9 points; renal/liver/drugs/alcohol separate; ESC 2024 context

The original HAS-BLED estimates major bleeding within one year in atrial fibrillation. The total is not an automatic contraindication to anticoagulation; factor definitions and contemporary guidance must match the version. Population calibration and antithrombotic treatment affect its interpretation.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Uncontrolled hypertension (systolic blood pressure > 160 mmHg)
Abnormal renal function (dialysis, transplant or creatinine ≥ 2.26 mg/dL)
Abnormal liver function (cirrhosis or bilirubin > 2× and AST/ALT > 3× normal)
Previous stroke
Prior bleeding or predisposition (anemia, thrombocytopenia)
Labile INR (time in therapeutic range < 60%)
Age > 65 years
Antiplatelet or anti-inflammatory medication
Alcohol (≥ 8 drinks per week)

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

One point each: Hypertension, Abnormal renal/liver function (1 each), Stroke, Bleeding, Labile INR, Elderly (> 65), Drugs/alcohol (1 each). Maximum: 9.

References

Identifier: has-bled

Original clinical content: Brazilian Portuguese.

Method version

HAS-BLED/Pisters 2010: 9 points; renal/liver/drugs/alcohol separate; ESC 2024 context

has-bled@native-2026-10-03+959eb61ec254

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Uncontrolled hypertension (systolic blood pressure > 160 mmHg): Yes
Abnormal renal function (dialysis, transplant or creatinine ≥ 2.26 mg/dL): Yes
Abnormal liver function (cirrhosis or bilirubin > 2× and AST/ALT > 3× normal): Yes
Previous stroke: Yes
Prior bleeding or predisposition (anemia, thrombocytopenia): Yes
Labile INR (time in therapeutic range < 60%): Yes
Age > 65 years: Yes
Antiplatelet or anti-inflammatory medication: Yes
Alcohol (≥ 8 drinks per week): Yes

{
  "h": true,
  "rim": true,
  "fig": true,
  "avc": true,
  "sang": true,
  "inr": true,
  "idoso": true,
  "drogas": true,
  "alcool": true
}

Expected result

{
  "score": 9
}

Actual result

{
  "score": 9
}

Case 2

reference-002

Inputs

Uncontrolled hypertension (systolic blood pressure > 160 mmHg): Yes
Previous stroke: Yes
Age > 65 years: Yes
Abnormal renal function (dialysis, transplant or creatinine ≥ 2.26 mg/dL): No
Abnormal liver function (cirrhosis or bilirubin > 2× and AST/ALT > 3× normal): No
Prior bleeding or predisposition (anemia, thrombocytopenia): No
Labile INR (time in therapeutic range < 60%): No
Antiplatelet or anti-inflammatory medication: No
Alcohol (≥ 8 drinks per week): No

{
  "h": true,
  "avc": true,
  "idoso": true,
  "rim": false,
  "fig": false,
  "sang": false,
  "inr": false,
  "drogas": false,
  "alcool": false
}

Expected result

{
  "score": 3
}

Actual result

{
  "score": 3
}

Case 3

reference-003

Inputs

Uncontrolled hypertension (systolic blood pressure > 160 mmHg): No
Abnormal renal function (dialysis, transplant or creatinine ≥ 2.26 mg/dL): No
Abnormal liver function (cirrhosis or bilirubin > 2× and AST/ALT > 3× normal): No
Previous stroke: No
Prior bleeding or predisposition (anemia, thrombocytopenia): No
Labile INR (time in therapeutic range < 60%): No
Age > 65 years: No
Antiplatelet or anti-inflammatory medication: No
Alcohol (≥ 8 drinks per week): No

{
  "h": false,
  "rim": false,
  "fig": false,
  "avc": false,
  "sang": false,
  "inr": false,
  "idoso": false,
  "drogas": false,
  "alcool": false
}

Expected result

{
  "score": 0
}

Actual result

{
  "score": 0
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.