Outpatient Bleeding Risk Index
Risk Factor | Points Awarded |
---|---|
Age >= 65 | 1 |
History of stroke | 1 |
History of gastrointestinal bleeding | 1 |
Presence of 1 or more comorbid conditions (recent MI; SCr > 1.5mg/dL; Hct < 30%; diabetes) |
1 |
Bleeding Risk Group | Observed Outpatient Risk of Major Bleeding | Observed Outpatient Risk of Minor Bleeding |
---|---|---|
0 points = Low Risk |
0.8 %/pt-yr | 8.5%/pt-yr |
1-2 points = Intermediate Risk | 2.6 %/pt-yr | 5.3 %/pt-yr |
3-4 points = High Risk |
9.7 %/pt-yr | 6.1 %/pt-yr |
HEMORR2HAGES
Letter | Clinical Characteristic | Points Awarded |
---|---|---|
H | Hepatic or renal disease | 1 |
E | Ethanol abuse | 1 |
M | Malignancy | 1 |
O | Older age (>75) | 1 |
R | Reduced platelet count or function | 1 |
R | Rebleeding risk (ie: prior bleed) | 2 |
H | Hypertension, uncontrolled | 1 |
A | Anemia | 1 |
G | Genetic factors (CYP2C9 variant) | 1 |
E | Excessive fall risk | 1 |
S | Stroke | 1 |
Risk Score | Incidence of Major Bleeding (%/pt-yr) |
---|---|
0 | 1.9 |
1 | 2.5 |
2 | 5.3 |
3 | 8.4 |
4 | 10.4 |
>=5 | 12.3 |
The HAS-BLED Score
Letter | Clinical Characteristic | Definition | Points Awarded |
---|---|---|---|
H | Hypertension | Uncontrolled; >160mmHg systolic | 1 |
A | Abnormal renal and/or liver function (1 point each) | Renal: chronic dialysis, renal transplant, or Scr> 2 Liver: chronic hepatic disease or laboratory evidence |
1 or 2 |
S | Stroke | Prior history of stroke | 1 |
B | Bleeding | Bleeding histor, anemia, or predisposition to bleeding | 1 |
L | Labile INRs | Therapeutic time-in-range < 60% | 1 |
E | Elderly | Age > 65 | 1 |
D | Drugs and/or alcohol | Drugs: concurrent antiplatelet agents or NSAIDS Alcohol: 8 or more drinks per week |
1 or 2 |
Risk Score | Incidence of Major Bleeding In Euro Heart Survey Patients (%/pt-yr) |
---|---|
0 | 1.13 |
1 | 1.02 |
2 | 1.88 |
3 | 3.74 |
4 | 8.7 |
5 | 12.5 |
6 | 0 bleeds/2 patients |
7 | 0 patients |
8 | 0 patients |
9 | 0 patients |