Predictive value of the HAS-BLED score for the risk of recurrent intracranial hemorrhage after first spontaneous intracranial hemorrhage.

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).

Conclusion: This study provided data on the risk of ICH recurrence stratified using the HAS-BLED score in patients after an ICH.