Table 4 Different models to assess patients’ haemorrhagic risk

HAS-BLED Score³⁷

Patients with atrial fibrillation

Hypertension – 1

Abnormal liver/renal function – 1/2

Stroke history – 1

Bleeding predisposition – 1

Labile INR – 1

Elderly (age > 65 years) – 1

Drug/alcohol usage − 1/2

≤ 1 (low risk) – anticoagulation should be considered

2 (moderate risk) – anticoagulation can be considered

3–5 (high risk) and > 5 (very high risk) – alternatives to anticoagulation should be considered

HEMORR₂HAGES Score³⁸

Elderly patients with atrial fibrillation

Hepatic or renal disease – 1

Ethanol abuse – 1

Malignancy – 1

Older (age > 75 years) – 1

Reduced platelet count or function – 1

Rebleeding (prior bleed) – 2

Hypertension (uncontrolled) – 1

Anemia – 1

Genetic factors (CYP2C9 SNP) – 1

Excessive fall risk – 1

Stroke – 1

≤ 1 (low risk) – consider anticoagulation if clinically indicated

2–3 (intermediate risk) – consider alternatives to anticoagulation unless strong indications for it exists

≥ 4 (high risk) – alternative options should often be considered

ATRIA Bleeding Risk Score³⁹

Patients in whom warfarin anticoagulation is being considered

Anemia – 3

Severe renal disease/Dialysis – 3

Age ≥ 75 years – 2

Prior hemorrhage – 1

Hypertension – 1

< 4 points (low risk) – reasonable to start warfarin

4 points (intermediate risk) – alternatives to warfarin therapy can be considered

> 4 points (high risk) – alternatives to warfarin should be strongly considered

ORBIT Score⁴⁰

Patients with atrial fibrillation

Anemia – 2

Age > 74 years – 1

Bleeding history – 1

GFR < 60 mL/min/1.73 m² – 1

Treatment with antiplatelet agents – 1

≤ 2 (low risk)

3 (medium risk)

4–7 (high risk)

Doesn´t make any recommendation regarding the use or not of hypocoagulation