Cardiology · Haematology
HEMORR2HAGES Score calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
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0
Low risk: 0–1 points (1.9–2.5 major bleeds per 100 patient-years)
Band: Low risk: 0–1 points (1.9–2.5 major bleeds per 100 patient-years)
Interpretation. Low risk: 0–1 points (1.9–2.5 major bleeds per 100 patient-years)
Suggested management. Major bleeding rates on warfarin in the NRAF cohort of Medicare patients with atrial fibrillation (score 0: 1.9, 1: 2.5, 2: 5.3, 3: 8.4, 4: 10.4, ≥5: 12.3 per 100 patient-years). Rates were calibrated on warfarin and may differ with other anticoagulants.
HEMORR2HAGES Score: 0 — Low risk: 0–1 points (1.9–2.5 major bleeds per 100 patient-years). Interpretation: Low risk: 0–1 points (1.9–2.5 major bleeds per 100 patient-years) What to do: Major bleeding rates on warfarin in the NRAF cohort of Medicare patients with atrial fibrillation (score 0: 1.9, 1: 2.5, 2: 5.3, 3: 8.4, 4: 10.4, ≥5: 12.3 per 100 patient-years). Rates were calibrated on warfarin and may differ with other anticoagulants. Inputs: Hepatic or renal disease (+1): false; Ethanol (alcohol) abuse (+1): false; Malignancy (+1): false; Age >75 years (+1): false; Reduced platelet count or function (+1): false; Rebleeding risk: prior bleed (+2): false; Uncontrolled hypertension (+1): false; Anaemia (+1): false; Genetic factors: CYP2C9 variant (+1): false; Excessive fall risk (+1): false; Stroke (+1): false Source: Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, Radford MJ. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719. DOI: 10.1016/j.ahj.2005.04.017. PMID: 16504638. Scope: HEMORR2HAGES: hepatic or renal disease +1, ethanol abuse +1, malignancy +1, older age (>75 years) +1, reduced platelet count or function +1, rebleeding risk (prior bleed) +2, uncontrolled hypertension +1, anaemia +1, genetic factors (CYP2C9 variants) +1, excessive fall risk +1, stroke +1 (maximum 12). Major bleeds per 100 patient-years of warfarin in NRAF: score 0 1.9, 1 2.5, 2 5.3, 3 8.4, 4 10.4, ≥5 12.3; grouped as low 0–1, intermediate 2–3, high ≥4. (2006)
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Clinical inputs
- Hepatic or renal disease (+1)
- Ethanol (alcohol) abuse (+1)
- Malignancy (+1)
- Age >75 years (+1)
- Reduced platelet count or function (+1)
- Rebleeding risk: prior bleed (+2)
- Uncontrolled hypertension (+1)
- Anaemia (+1)
- Genetic factors: CYP2C9 variant (+1)
- Excessive fall risk (+1)
- Stroke (+1)
Primary source
Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, Radford MJ. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713-719. DOI: 10.1016/j.ahj.2005.04.017. PMID: 16504638. Scope: HEMORR2HAGES: hepatic or renal disease +1, ethanol abuse +1, malignancy +1, older age (>75 years) +1, reduced platelet count or function +1, rebleeding risk (prior bleed) +2, uncontrolled hypertension +1, anaemia +1, genetic factors (CYP2C9 variants) +1, excessive fall risk +1, stroke +1 (maximum 12). Major bleeds per 100 patient-years of warfarin in NRAF: score 0 1.9, 1 2.5, 2 5.3, 3 8.4, 4 10.4, ≥5 12.3; grouped as low 0–1, intermediate 2–3, high ≥4. (2006)
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