title: Predictive value of the HAS-BLED score for the risk of recurrent intracranial hemorrhage after first spontaneous intracranial hemorrhage.
abstract: BACKGROUND
  Patients who survive intracranial hemorrhage (ICH) are at high risk of recurrence. The Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (Age >65 years), Drugs/Alcohol Concomitantly (HAS-BLED) score has recently been developed to assess bleeding risk.
  
  
  METHODS
  This observational study was aimed to investigate the prognostic performance of the HAS-BLED score in predicting recurrent ICH. Consecutive patients (434) with a first spontaneous ICH who were not prescribed antiplatelet or anticoagulation therapy (59.8 ± 15.3 years; men, 62.3%) were recruited.
  
  
  RESULTS
  Most patients (71.6%) had a HAS-BLED score of >1. After a follow-up of 52.7 months, there were 42 ICH recurrences (2.25 per 100 patient-years). The risk of ICH recurrence increased with HAS-BLED score. Specifically, the risk of ICH recurrence with HAS-BLED score of 1, 2, 3, and 4 were 1.37, 2.38, 3.39, and 2.90 per 100 patient-years, respectively. The sensitivity and specificity of HAS-BLED was 79.1% and 29.2%, respectively, with C-statistic of 0.54 (0.50-0.59).
  
  
  CONCLUSIONS
  This study provided data on the risk of ICH recurrence stratified using the HAS-BLED score in patients after an ICH.
authors.affiliation: Neurology Division, Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Koon-Ho
authors.initials: KH
authors.lastname: Chan
authors.affiliation: Division of Neurosurgery, Department of Surgery, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Ka-Kit Leung
authors.affiliation: Neurology Division, Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Kui-Kai
authors.initials: KK
authors.lastname: Lau
authors.affiliation: Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Liu
authors.affiliation: Division of Neurosurgery, Department of Surgery, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Wai-Man
authors.initials: WM
authors.lastname: Lui
authors.affiliation: Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Chu Pak
authors.initials: CP
authors.lastname: Lau
authors.affiliation: Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
authors.affiliation: Division of Neurosurgery, Department of Surgery, the University of Hong Kong, Hong Kong SAR, People's Republic of China. Electronic address: ksjpu@hkucc.hku.hk.
authors.forename: Jenny
authors.initials: J
authors.lastname: Kan-Suen Pu
authors.affiliation: Cardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China. Electronic address: cwdsiu@hkucc.hku.hk.
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000175:diagnosis; D003627:Data Interpretation, Statistical; D023381:Endpoint Determination; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D019934:International Normalized Ratio; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000175:diagnosis*; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000175:diagnosis; D016896:Treatment Outcome
keywords: HAS-BLED score; Intracranial hemorrhage; Recurrence