The authors present a case report suggesting that revisions to the HAS-BLED score may improve major bleeding risk estimation in patients with atrial fibrillation and intracerebral hemorrhage.
Caution against HAS-BLED revision from single cases; leaves open validation in larger AF-ICH cohorts.
Many efforts have been made to develop decision-support tools and bleeding prediction schemes to start or resume anticoagulation after intracerebral hemorrhage, related with anticoagulation use or not, such as CHA2DS2-VASc or HAS-BLED scoring. HAS-BLED is a validated scoring system to predict the risk of major bleeding in a patient with atrial fibrillation; some current scientific guidelines suggest its use in 'risk-benefit' reasoning when deciding whether to start long-term oral anticoagulation. Here the authors present a patient with atrial fibrillation and intracerebral hemorrhage, and aim to discuss the use of HAS-BLED, suggesting that some revisions may help better management of these patients for major bleeding risk.
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İnce et al. (2014) studied this question.
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