High Bleeding Risk (HBR) Diagnosis Score Tool

Age seventy five years or older

Prior bleeding requiring hospitalization or transfusion

Chronic kidney disease with eGFR under thirty ml per minute

Hemoglobin under eleven g per dL or need for transfusion within four weeks

Platelet count under one hundred thousand per microliter

Stroke history or intracranial hemorrhage

Active cancer within the last year

Use of oral anticoagulant at baseline

High Bleeding Risk Diagnosis Score Tool Explanation and Clinical Context
This calculator summarizes major bleeding related factors highlighted in the twenty twenty five American Heart Association acute coronary syndrome guideline to assist clinicians in identifying patients who have elevated bleeding potential during antithrombotic therapy. The variables reflect clinical domains frequently associated with hemorrhagic events such as advanced age prior major bleeding kidney dysfunction anemia thrombocytopenia intracranial events active malignancy and use of oral anticoagulants. A total score of two or more suggests high bleeding risk and supports consideration of shorter DAPT window de escalation strategies or careful balancing of ischemic benefit against hemorrhagic harm. This tool is intended to complement clinical judgement rather than replace individualized assessment since bleeding and ischemic risks evolve over time and patient goals comorbidity burden renal function procedural complexity and troponin profile remain critical in decision making.

Reference:
ACC AHA ACS Clinical Practice Guideline Twenty Twenty Five. High bleeding risk considerations for ACS antithrombotic therapy. Journal of the American College of Cardiology Twenty Twenty Five.
Urban P et al. Defining high bleeding risk in patients undergoing PCI. Circulation Twenty Nineteen.

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