Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

Peter Rief; Reinhard Bernd Raggam; Franz Hafner; Alexander Avian; Gerald Hackl; Gerhard Cvirn; Marianne Brodmann; Thomas Gary

doi:10.1055/s-0037-1607433

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2018; 44(04): 348-352
DOI: 10.1055/s-0037-1607433

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Calculation of HAS-BLED Score Is Useful for Early Identification of Venous Thromboembolism Patients at High Risk for Major Bleeding Events: A Prospective Outpatients Cohort Study

Authors

Peter Rief

¹Department of Angiology, Medical University of Graz, Graz, Austria
Reinhard Bernd Raggam

¹Department of Angiology, Medical University of Graz, Graz, Austria
Franz Hafner

¹Department of Angiology, Medical University of Graz, Graz, Austria
Alexander Avian

²Department of Medical Informatics, Statistics and Information, Medical University of Graz, Graz, Austria
Gerald Hackl

³Department of Internal Medicine, Medical University of Graz, Graz, Austria
Gerhard Cvirn

⁴Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
Marianne Brodmann

¹Department of Angiology, Medical University of Graz, Graz, Austria
Thomas Gary

¹Department of Angiology, Medical University of Graz, Graz, Austria

Abstract

The aim of this study was prospective evaluation of the performance of the HAS-BLED score in predicting major bleeding complications in a real-world outpatient cohort, during long-term anticoagulation for venous thromboembolism (VTE), treated with a broad spectrum of anticoagulants. We analyzed 111 outpatients objectively diagnosed with VTE and treated long-term with various anticoagulants. Patients were grouped in three cohorts based on the anticoagulant regimen. Calculation of the HAS-BLED score and documentation of bleeding events were performed every 6 months for 1 year. Patients with a HAS-BLED score ≥ 3 had an increased risk for major bleeding events (odds ratio [OR]: 13.05, 95% confidence interval [CI]: 0.96–692.58, p = 0.028) and a trend to higher risk for minor bleeding events as well (OR: 2.25, 95% CI: 0.87–5.85, p = 0.091) when compared with patients with a HAS-BLED score < 3.This indicates that a HAS-BLED score ≥ 3 allows for identification of patients with VTE on long-term anticoagulation at an increased risk for major bleeding events, irrespective of the anticoagulant agent used.

Keywords

HAS-BLED score - venous thromboembolism - bleeding complications - anticoagulant treatment

Full Text

References

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