HAS-BLED — Bleeding risk on anticoagulation

Pre-procedure anticoagulation + neuraxial bleeding risk awareness

Mnemonic device

HAS-BLED (each = 1 point; ≥3 = high bleeding risk)

Mapping

H — Hypertension uncontrolled (SBP >160)

1 pt

A — Abnormal renal/liver function

1 pt each (max 2)

S — Stroke history

1 pt

B — Bleeding history or predisposition

1 pt

L — Labile INR (TTR <60%)

1 pt

E — Elderly (>65)

1 pt

D — Drugs (antiplatelet/NSAID) or alcohol

1 pt each (max 2)

Clinical note: Score ≥3 = high bleeding risk on anticoag. HAS-BLED is for chronic anticoag decisions, NOT a contraindication to neuraxial — for that use ASRA Coags 4th-edition timing tables. The risk factors overlap and a high HAS-BLED = think twice + escalate.