title: Should HAS-BLED scoring be revised for better risk estimation in patients with intracerebral hemorrhage?
abstract: Many efforts have been made to develop decision-support tools and bleeding prediction schemes to start or resume anticoagulation after intracerebral hemorrhage, related with anticoagulation use or not, such as CHA2DS2-VASc or HAS-BLED scoring. HAS-BLED is a validated scoring system to predict the risk of major bleeding in a patient with atrial fibrillation; some current scientific guidelines suggest its use in 'risk-benefit' reasoning when deciding whether to start long-term oral anticoagulation. Here the authors present a patient with atrial fibrillation and intracerebral hemorrhage, and aim to discuss the use of HAS-BLED, suggesting that some revisions may help better management of these patients for major bleeding risk.
authors.affiliation: Department of Neurology, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
authors.forename: Birsen
authors.initials: B
authors.lastname: Ince
authors.forename: Gulcin
authors.initials: G
authors.lastname: Benbir
authors.forename: Gokcen
authors.initials: G
authors.lastname: Gozubatik-Celik
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000503:physiopathology*; D003661:Decision Support Techniques; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors
chemical_list: D000925:Anticoagulants
keywords: HAS-BLED scoring; anticoagulation; bleeding risk; intracerebral hemorrhage; revisions