Assessing bleeding risk with the HAS-BLED score: Balancing simplicity, practicality, and predictive value in bleeding-risk assessment

Clinical Cardiology

Volumn 38, Issue 9, 2015, Pages 562-564

  Lip, Gregory Y H ^a,b  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

^b AALBORG UNIVERSITY   (Denmark)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICOAGULANT AGENT;

ACUTE CORONARY SYNDROME; ALCOHOL CONSUMPTION; ATRIA SCORE; ATRIAL FIBRILLATION; BLEEDING; BRAIN HEMORRHAGE; CARDIOVASCULAR DISEASE ASSESSMENT; CEREBROVASCULAR ACCIDENT; CHA2DS2 VASC SCORE; CHADS2 SCORE; CLINICAL PRACTICE; COMORBIDITY; CORONARY STENTING; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST ACCURACY STUDY; EDITORIAL; ELDERLY CARE; HAS BLED SCORE; HEMORR2HAGES SCORE; HUMAN; HYPERTENSION; INTERMETHOD COMPARISON; INTERNATIONAL NORMALIZED RATIO; MEDICAL DECISION MAKING; META ANALYSIS (TOPIC); PERCUTANEOUS CORONARY INTERVENTION; PRACTICE GUIDELINE; PREDICTIVE VALUE; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; RISK FACTOR; SYSTEMATIC REVIEW (TOPIC); BLOOD CLOTTING; CHEMICALLY INDUCED; DECISION SUPPORT SYSTEM; DRUG EFFECTS; FEMALE; MALE;

ANTICOAGULANTS; ATRIAL FIBRILLATION; BLOOD COAGULATION; DECISION SUPPORT TECHNIQUES; FEMALE; HEMORRHAGE; HUMANS; MALE;

EID: 84942592386     PISSN: 01609289     EISSN: 19328737     Source Type: Journal    
DOI: 10.1002/clc.22436     Document Type: Editorial

References (20)

1. Lip GY, Andreotti F, Fauchier L, et al., Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis. Thromb Haemost. 2011; 106: 997-1011.
2. Lip GY, Zarifis J, Watson RD, et al., Physician variation in the management of patients with atrial fibrillation. Heart. 1996; 75: 200-205.
3. Pisters R, Lane DA, Nieuwlaat R, et al., A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010; 138: 1093-1100.
4. Omran H, Bauersachs R, Rubenacker S, et al., The HAS-BLED score predicts bleedings during bridging of chronic oral anticoagulation. Results from the national multicentre BNK Online bRiDging REgistRy (BORDER). Thromb Haemost. 2012; 108: 65-73.
5. Smith JG, Wieloch M, Koul S, et al., Triple antithrombotic therapy following an acute coronary syndrome: prevalence, outcomes and prognostic utility of the HAS-BLED score. EuroIntervention. 2012; 8: 672-678.
6. Apostolakis S, Lane DA, Guo Y, et al., Performance of the HEMORR(2)HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in patients with atrial fibrillation undergoing anticoagulation: the AMADEUS (evaluating the use of SR34006 compared to warfarin or acenocoumarol in patients with atrial fibrillation) study. J Am Coll Cardiol. 2012; 60: 861-867.
7. Apostolakis S, Lane DA, Buller H, et al., Comparison of the CHADS2, CHA2DS2-VASc and HAS-BLED scores for the prediction of clinically relevant bleeding in anticoagulated patients with atrial fibrillation: the AMADEUS trial. Thromb Haemost. 2013; 110: 1074-1079.
8. Roldan V, Marin F, Manzano-Fernandez S, et al., The HAS-BLED score has better prediction accuracy for major bleeding than CHADS2 or CHA2DS2-VASc scores in anticoagulated patients with atrial fibrillation. J Am Coll Cardiol. 2013; 62: 2199-2204.
9. Roldan V, Marin F, Fernandez H, et al., Predictive value of the HAS-BLED and ATRIA bleeding scores for the risk of serious bleeding in a «real-world» population with atrial fibrillation receiving anticoagulant therapy. Chest. 2013; 143: 179-184.
10. Apostolakis S, Lane DA, Guo Y, et al., Performance of the HEMORR 2 HAGES, ATRIA, and HAS-BLED bleeding risk-prediction scores in nonwarfarin anticoagulated atrial fibrillation patients. J Am Coll Cardiol. 2013; 61: 386-387.
11. Lip GY, Banerjee A, Lagrenade I, et al., Assessing the risk of bleeding in patients with atrial fibrillation: the Loire Valley Atrial Fibrillation project. Circ Arrhythm Electrophysiol. 2012; 5: 941-948.
12. Zhu W, He W, Guo L, et al., The HAS-BLED score for predicting major bleeding risk in anticoagulated patients with atrial fibrillation: a systematic review and meta-analysis. Clin Cardiol. 2015; 38: XXX-XXX.
13. National Institute for Health and Care Excellence. Atrial fibrillation: the management of atrial fibrillation. Clinical guideline 180. 2014. http://guidance.nice.org.uk/CG180. Accessed August 27, 2015.
14. Camm AJ, Lip GY, De Caterina R, et al., 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation-developed with the special contribution of the European Heart Rhythm Association. Europace. 2012; 14: 1385-1413.
15. Olesen JB, Lip GY, Lindhardsen J, et al., Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a 'real world' nationwide cohort study. Thromb Haemost. 2011; 106: 739-749.
16. Wan Y, Heneghan C, Perera R, et al., Anticoagulation control and prediction of adverse events in patients with atrial fibrillation: a systematic review. Circ Cardiovasc Qual Outcomes. 2008; 1: 84-91.
17. Gallego P, Roldan V, Marin F, et al., Cessation of oral anticoagulation in relation to mortality and the risk of thrombotic events in patients with atrial fibrillation. Thromb Haemost. 2013; 110: 1189-1198.
18. De Caterina R, Husted S, Wallentin L, et al., Vitamin K antagonists in heart disease: current status and perspectives (Section III). Position paper of the ESC Working Group on Thrombosis-Task Force on Anticoagulants in Heart Disease. Thromb Haemost. 2013; 110: 1087-1107.
19. Berwaerts J, Webster J,. Analysis of risk factors involved in oral-anticoagulant-related intracranial haemorrhages. QJM. 2000; 93: 513-521.
20. Lip GY,. Stroke and bleeding risk assessment in atrial fibrillation: when, how, and why? Eur Heart J. 2013; 34: 1041-1049.