Assessing Bleeding Risk With the HASâBLED Score: Balancing Simplicity, Practicality, and Predictive Value in BleedingâRisk Assessment
. Bleeding risk assessment and management in atrial fibrillation patients. Nonetheless, clinicians have been poor at estimating bleeding risk, with a tendency to overestimate risks in particular patients. This score would help as a potential practical tool in clinical decision making, rather than 'guessing' the bleeding risk. However, would such an approach of adding additional tests help clinical application and practicality, or would oversimplification by reducing the number of clinical parameters really help the patient by misclassifying the patient as low risk? In clinical practice, we know that bleeding risk can be associated with a number of common clinical factors.
Bleeding Risk in Atrial Fibrillation: HAS
It is matched to the used for stroke risk stratification. It is recommended by the new European Society of Cardiology guidelines and the Canadian guidelines on atrial fibrillation management. In a recent article validating the score, and were identified as additional risk factors for bleeding. In the present issue of Clinical Cardiology, Zhu et al. A balance would be needed between simplicity and practicalityâas well as predictive value, and as Zhu et al. One can certainly add in biomarkers or imaging techniques eg, small vessel disease or microbleeds on cerebral imaging , but introduce additional complexity and costs of additional tests, with only a marginal improvement in predictive value, which may well be statistically significant; the clinical significance could be open to debate. Canadian cardiovascular society atrial fibrillation guidelines 2010: prevention of stroke and systemic thromboembolism in atrial fibrillation and flutter.
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The author has no other funding, financial relationships, or conflicts of interest to disclose. . . . . .
