{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:45:12Z","timestamp":1792403112064,"version":"4.4.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,3,20]]},"abstract":"\n Background<\/jats:title>\n \n The Hypertension, Abnormal renal\/liver function, Stroke, Bleeding, Labile International Normalized Ratio (INR), Elderly, Drugs or alcohol use (\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n ) score has strong predictive validity for major bleeding complications, but limited validation has been conducted in venous thromboembolism (\n VTE<\/jats:styled-content>\n ). This study evaluates the\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n score in a large cohort of\n VTE<\/jats:styled-content>\n patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A retrospective cohort of adults \u226518\u00a0years with primary diagnosis of\n VTE<\/jats:styled-content>\n between January 1, 2010 and November 31, 2013 were identified in an insurance claims database. Patients were tracked until death, any bleed event, or end of study period.\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n score and components were evaluated via proportional hazard models. Cumulative incidence functions were reported at 30, 60, 90, and 180\u00a0days. N=132\u00a0280 patients with a\n VTE<\/jats:styled-content>\n were identified, with 73.8% having\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n scores of 0 to 2, 3.6% score \u22654, and 4789 bleeding events (3.6% all patients). A 1\u2010point\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n score increase was associated with 20% to 30% bleeding rate increase overall, but in a cancer cohort only the increase from 3\u2010 to 4\u2010points was significant for all bleeds (cs\n HR<\/jats:styled-content>\n =1.41, 95%\n CI<\/jats:styled-content>\n : 1.17\u20131.69; sd\n HR<\/jats:styled-content>\n =1.40, 95%\n CI<\/jats:styled-content>\n : 1.17\u20131.69) and major bleeds (cs\n HR<\/jats:styled-content>\n =1.66, 95%\n CI<\/jats:styled-content>\n : 1.26\u20132.20; sd\n HR<\/jats:styled-content>\n =1.66, 95%\n CI<\/jats:styled-content>\n : 1.25\u20132.19). Adding cancer to the model as an independent covariate provided the strongest association among all covariates, with cs\n HR<\/jats:styled-content>\n =2.25 (95%\n CI<\/jats:styled-content>\n : 1.98\u20132.56) and sd\n HR<\/jats:styled-content>\n =2.11 (95%\n CI<\/jats:styled-content>\n : 1.85\u20132.41) in the model for major bleeds.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n score has good predictive validity for bleeding risks in patients with VTE. The addition of cancer as an independent bleeding risk factor merits consideration, possibly as part of the \u201cB\u201d criterion (\u201cbleeding tendency or predisposition\u201d).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007901","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T01:10:33Z","timestamp":1520471433000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Risk Stratification for Bleeding Complications in Patients With Venous Thromboembolism: Application of the HAS\u2010BLED Bleeding Score During the First 6\u00a0Months of Anticoagulant Treatment"],"prefix":"10.1161","volume":"7","author":[{"given":"Joshua D.","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie J.","family":"Goodin","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes & Policy, University of Florida College of Pharmacy, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University of Birmingham, United Kingdom"},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val R.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice & Science, University of Kentucky College of Pharmacy, Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-015-1311-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2015.11.026"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2304"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.024"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0122520"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2010.03.009"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.5954"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-016-0189-9"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017719"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.7351"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13386"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-0608"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13009"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-04-460121"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00280-2016"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22435"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1598061"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-01-0081"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.04.048"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare4010016"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.007901","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:07:53Z","timestamp":1715598473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.007901"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,20]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,3,20]]}},"alternative-id":["10.1161\/JAHA.117.007901"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.007901","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,20]]},"assertion":[{"value":"2017-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007901"}}