cliot (version 1.0.0)

has_bled_score: HAS-BLED Score for Major Bleeding Risk

Description

Calculates the HAS-BLED score to estimate the 1-year risk of major bleeding in patients with atrial fibrillation who are being considered for or are taking oral anticoagulation. It helps clinicians assess the risk-benefit ratio of anticoagulation therapy and identify modifiable risk factors.

Usage

has_bled_score(hypertension, abnormal_renal_function, abnormal_liver_function,
               stroke_history, bleeding_history, labile_inr, elderly_gt_65,
               drug_usage, alcohol_usage)

Value

A list containing:

HAS_BLED_Score

The calculated score (Range 0-9).

Annual_Bleeding_Risk

Estimated annual risk of major bleeding events.

Recommendation

Clinical guidance based on the risk level.

Arguments

hypertension

Numeric (0 or 1). Uncontrolled systolic blood pressure > 160 mmHg. (1 = Yes, +1 point).

abnormal_renal_function

Numeric (0 or 1). Chronic dialysis, renal transplantation, or serum creatinine >= 2.26 mg/dL. (1 = Yes, +1 point).

abnormal_liver_function

Numeric (0 or 1). Chronic hepatic disease (e.g., cirrhosis) or biochemical evidence of significant hepatic derangement. (1 = Yes, +1 point).

stroke_history

Numeric (0 or 1). History of previous ischemic stroke. (1 = Yes, +1 point).

bleeding_history

Numeric (0 or 1). Prior major bleeding or predisposition to bleeding (e.g., anemia). (1 = Yes, +1 point).

labile_inr

Numeric (0 or 1). Unstable/high INRs or time in therapeutic range < 60%. (1 = Yes, +1 point).

elderly_gt_65

Numeric (0 or 1). Age > 65 years. (1 = Yes, +1 point).

drug_usage

Numeric (0 or 1). Concomitant use of antiplatelets (e.g., aspirin, clopidogrel) or NSAIDs. (1 = Yes, +1 point).

alcohol_usage

Numeric (0 or 1). Alcohol abuse or intake > 8 drinks/week. (1 = Yes, +1 point).

References

Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093-1100. doi:10.1378/chest.10-0134

Examples

# Example 1: High Risk
# HTN (1), Renal (1), Stroke (1), Elderly (1), Drugs (1)
# Score = 5
has_bled_score(1, 1, 0, 1, 0, 0, 1, 1, 0)

# Example 2: Low Risk
# Only Elderly (1)
# Score = 1
has_bled_score(0, 0, 0, 0, 0, 0, 1, 0, 0)