What is the predictive value of bleeding risk scores for identifying high risk patients who sustain events?
Most bleeding risk scores based on simple clinical risk factors only have modest predictive value for identifying the high risk patients who sustain events, with c-indexes of approximately 0.6. Systematic reviews have found that the HAS-BLED score performs better than the HEMORR2HAGES and ATRIA bleeding scores but was superior to the CHADS2 and CHA2DS2-VASc stroke scores for bleeding prediction. In a real-world AF cohort, there was no long-term advantage of the ABC- bleeding score over the HAS-BLED score, for predicting bleeding; in contrast, HAS-BLED was better in identifying those patients at low risk of bleeding.