Oral Anticoagulation and the Novel Oral Anticoagulants (NOACs):Where Are We at Midterm?

Academic Content

Program Overview

Faculty Presentations

Introduction Deepak L. Bhatt Elaine Hylek

Video Roundtable

Current Activity

Elaine Hylek, MD, MPH, Boston University School of Medicine, Boston, Massachusetts

NOACs in Clinical Care NOACS Prevention Data NOACS: Major Bleeding Meta-Analysis ESC 2012 Guidelines Update Garfield Registry Prophylaxis vs Anticoagulation Clinical Trial: Major Bleeding Benefit and Risk Bleeding Risk Score Consensus Statements CHA2DS2-VASc Bleeding Risk Score Circulation Article Patient Age vs TTR NOACs vs Warfarin NOACS & Renal Dysfunction EHRA NOACs Practical Guide Procedural Management NOACs Bleeding Management Life-threatening Hemorrhage CAT Scans of Cerebral Hemorrhage Intracerebral Hemorrhage: Limited Data Kcentra: FDA approval Safety: Meta-analysis Anticoagulation Antidotes Dose Differences: AFib vs VTE NOACS in Clinical Practice Continuing role for warfarin?

Return to:

The American Journal of Medicine

« Prev

Next »
Click Figure to Enlarge

Update Required To play the media you will need to either update your browser to a recent version or update your Flash plugin.

The American Journal of Medicine

Print This Page

HAS-BLED Bleeding Risk Score

Figure 13 uses the same graph as shown in Figure 10 to address how physicians might use the HAS-BLED score.[7] Personally I use this score when I am with a patient who has been prescribed anticoagulation, to remind me of the things that I can do to help my patient avoid a serious bleed.

1) I cannot change their age, but I certainly can change their use of aspirin.

2) I can certainly warn them about using ibuprofen or NSAIDs, because that greatly increases the risk of bleeding by 19-fold.

3) I can certainly pay attention to their blood pressure control.

Thus in my large anticoagulation practice I use the HAS-BLED score more as a checklist to remind me to ask the patient: "Have any of these changed? What's the renal function? How is your liver?"

Hylek EM. Am J Med 2014; 00.

References

[7]

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.