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CHA2DS2VASc & HAS-BLED

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CHA2DS2VASc scoring tool 

  • Assesses a person's stroke risk
  • Add together the points allocated to each risk factor
  • Refer to the table below to calculate the percantage risk
Points Risk Factor Additional notes
1 Age 65–74 years  
2 Age >74 years  
1 Sex category (female)  
1 Congestive heart failure/left ventricular dysfunction  heart failure with reduced ejection fraction, or people with recent decompensated heart failure requiring hospitalization, irrespective of ejection fraction
1 Hypertension defined as a resting blood pressure greater than 140 mmHg systolic and/or greater than 90 mmHg diastolic on at least 2 occasions or current antihypertensive pharmacologic treatment
1 Diabetes mellitus  defined as fasting plasma glucose level of 7.0 mmol/L [126 mg/dL] or more or treatment with oral hypoglycaemic drugs and/or insulin
2 Stroke/TIA  
1 Vascular disease prior myocardial infarction, peripheral arterial disease, or aortic plaque
 
Score
Stroke rate risk (%)
1
1,3%
2
2,2%
3
3,2%
4
4,0%
5
6,7%
6
9,8%
7
9,6%
8
6,7%
9
15,2%

CHAD2VASC Scoring Tool 

The HAS-BLED scoring tool

  • Assesses the 1-year risk for major bleeding associated with oral anticoagulation
    • Patients with a high risk of bleeding (HAS-BLED score ≥ 3) warrent caution when prescribing oral anticoagulation and regular review is recommended
  • Identifies people at high risk of bleeding who could benefit from increased vigilance and a specific focus on correction of modifiable risk factors such as
    • uncontrolled hypertension
    • poor control of international normalized ratio (INR)
    • concurrent medication (for example concurrent use of aspirin or a nonsteroidal anti-inflammatory drug)
    • harmful alcohol consumption

A score of 1 point should be given for each of the following risk factors: 

A HAS-BLED score of ≥3 indicates that

Points

Risk Factor

Additional notes
1

Hypertension 

uncontrolled, greater than 160 mmHg systolic
1

Abnormal liver/renal function

 
1 Stroke  previous history, particularly lacunar strokes
1 Bleeding bleeding history or predisposition
1 Labile international normalized ratios INRs, therapeutic time in range less than 60%
1 Elderly   Age > 65 years
1 Drugs/ Alcohol antiplatelet agents or nonsteroidal anti-inflammatory drugs

HAS-BLED Tool 

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