Hemorr2hages Score
Estimates major bleeding risk in adults with atrial fibrillation.
When to use
Adults with atrial fibrillation, to stratify major bleeding risk.
Pearls and pitfalls
- Prior bleeding scores 2 points; the other factors score 1 point.
- The score includes anemia, renal disease, liver disease, alcohol, malignancy and low platelets.
- High risk does not contraindicate anticoagulation; it requires factor review and monitoring.
- The score predates direct anticoagulants and should be interpreted with caution.
0/12 points
Low risk
Keep monitoring and reassess risk periodically.
Formula
Add age above 75, prior bleeding (2), hypertension, anemia, prior stroke, renal or liver disease, alcohol, malignancy, low platelets, genetic factors and fall risk.
Evidence
Scheme derived in the National Registry of Atrial Fibrillation to predict bleeding in anticoagulated patients.
References
- Gage BF, Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719. doi:10.1016/j.ahj.2005.04.017
Frequently asked questions
What is Hemorr2hages Score?
Estimates major bleeding risk in adults with atrial fibrillation. Adults with atrial fibrillation, to stratify major bleeding risk.
How is the result calculated?
Add age above 75, prior bleeding (2), hypertension, anemia, prior stroke, renal or liver disease, alcohol, malignancy, low platelets, genetic factors and fall risk.
How should the result be interpreted?
Scheme derived in the National Registry of Atrial Fibrillation to predict bleeding in anticoagulated patients.
What are the sources?
Gage BF, Yan Y, Milligan PE, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719.