MDCalc

HEMORR₂HAGES Score for Major Bleeding Risk

Quantifies risk of hemorrhage in elderly patients with AFib.

The HEMORR₂HAGES Score was developed using ICD-9 data; while we are actively reaching out to its study authors, the terms included in the score are not defined in the study.

Hepatic or Renal Disease

Ethanol (Alcohol) Abuse

Malignancy History

Older (Age >75)

Reduced Platelet Count or Function

Includes aspirin use, any thrombocytopenia or blood dyscrasia, like hemophilia

Rebleeding Risk

History of past bleeding

Hypertension (Uncontrolled)

Anemia

Hgb <13 g/dL for Men; Hgb <12 g/dL for Women

Genetic Factors

CYP 2C9 single-nucleotide polymorphisms

Excessive Fall Risk

Stroke History

Result:

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Critical Actions
  • Risks and benefits of anticoagulation should be carefully considered in ALL patients prior to initiating therapy.
  • Other risk stratification scores such as HAS-BLED or ATRIA should also be taken into consideration prior to starting anticoagulation.
  • Alternative options should often be considered in patients with high-risk of major bleeding events in need of anticoagulation.
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