{"id":13826,"date":"2020-10-27T09:19:47","date_gmt":"2020-10-27T08:19:47","guid":{"rendered":"https:\/\/www.inanutshell.ch\/?page_id=13826"},"modified":"2020-11-02T11:32:17","modified_gmt":"2020-11-02T10:32:17","slug":"score-has-bled","status":"publish","type":"page","link":"https:\/\/www.inanutshell.ch\/fr\/calculateurs\/score-has-bled\/","title":{"rendered":"Score HAS-BLED"},"content":{"rendered":"<p>Le score HAS-BLED \u00e9value le risque de saignement majeur \u00e0 1 an des patients atteints de fibrillation auriculaire et trait\u00e9s par anticoagulants. Exemples de saignement majeur : h\u00e9morragie intracr\u00e2nienne, n\u00e9cessit\u00e9 d\u2019hospitaliser, chute notable de l\u2019h\u00e9moglobine, n\u00e9cessit\u00e9 de transfuser. Le <a href=\"https:\/\/www.inanutshell.ch\/fr\/calculateurs\/score-cha2ds2-vasc\/\">score CHA<sub>2<\/sub>DS<sub>2<\/sub>-VASc<\/a> permet d\u2019\u00e9valuer le risque d&rsquo;AVC et de thromboembolie chez les patients avec fibrillation auriculaire.<\/p>\n    <div class=\"medical-calculator has-bled\" id=\"medical-calculator-has-bled\">\r\n        <form>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label mt-auto\">\r\n                                    Hypertension\r\n                                <\/div>\r\n                <div class=\"col-sm-4\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"arterial-hypertonia\" id=\"medical-calculator-has-bled-arterial-hypertonia-n\" value=\"N\" tabindex=\"1\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"arterial-hypertonia\" id=\"medical-calculator-has-bled-arterial-hypertonia-y\" value=\"Y\" tabindex=\"2\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label\">\r\n                                    Maladie r\u00e9nale<br \/>\r\n                    <span class=\"label-lighter\">Dialyse, transplantation, cr\u00e9atinine &ge; 200 \u00b5mol\/l<\/span>\r\n                                <\/div>\r\n                <div class=\"col-sm-4 mt-sm-3\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"abnormal-kidney\" id=\"medical-calculator-has-bled-abnormal-kidney-n\" value=\"N\" tabindex=\"3\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"abnormal-kidney\" id=\"medical-calculator-has-bled-abnormal-kidney-y\" value=\"Y\" tabindex=\"4\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label\">\r\n                                    Maladie h\u00e9patique<br \/>\r\n                    <span class=\"label-lighter\">Cirrhose, bilirubine &gt; 2N et ASAT\/ALAT &gt; 3N<\/span>\r\n                                <\/div>\r\n                <div class=\"col-sm-4 mt-sm-3\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"abnormal-liver\" id=\"medical-calculator-has-bled-abnormal-liver-n\" value=\"N\" tabindex=\"5\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"abnormal-liver\" id=\"medical-calculator-has-bled-abnormal-liver-y\" value=\"Y\" tabindex=\"6\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label mt-auto\">\r\n                                    Ant\u00e9c\u00e9dents d\u2019AVC\r\n                                <\/div>\r\n                <div class=\"col-sm-4\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"prev-strokes\" id=\"medical-calculator-has-bled-prev-strokes-n\" value=\"N\" tabindex=\"7\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"prev-strokes\" id=\"medical-calculator-has-bled-prev-strokes-y\" value=\"Y\" tabindex=\"8\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label mt-auto\">\r\n                                    Tendance aux saignements ou ant\u00e9c\u00e9dents de saignements\r\n                                <\/div>\r\n                <div class=\"col-sm-4\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"bleeding-tendency\" id=\"medical-calculator-has-bled-bleeding-tendency-n\" value=\"N\" tabindex=\"9\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"bleeding-tendency\" id=\"medical-calculator-has-bled-bleeding-tendency-y\" value=\"Y\" tabindex=\"10\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label mt-auto\">\r\n                                    INR instable\r\n                                <\/div>\r\n                <div class=\"col-sm-4\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"labile-inr\" id=\"medical-calculator-has-bled-labile-inr-n\" value=\"N\" tabindex=\"11\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"labile-inr\" id=\"medical-calculator-has-bled-labile-inr-y\" value=\"Y\" tabindex=\"12\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label mt-auto\">\r\n                                    \u00c2ge &gt; 65 ans\r\n                                <\/div>\r\n                <div class=\"col-sm-4\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"age-lt-65y\" id=\"medical-calculator-has-bled-age-lt-65y-n\" value=\"N\" tabindex=\"13\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"age-lt-65y\" id=\"medical-calculator-has-bled-age-lt-65y-y\" value=\"Y\" tabindex=\"14\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label\">\r\n                                    M\u00e9dicaments favorisant les saignements<br \/>\r\n                    <span class=\"label-lighter\">Antiagr\u00e9gants, AINS<\/span>\r\n                                <\/div>\r\n                <div class=\"col-sm-4 mt-sm-3\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"bleed-stim-meds\" id=\"medical-calculator-has-bled-bleed-stim-meds-n\" value=\"N\" tabindex=\"15\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"bleed-stim-meds\" id=\"medical-calculator-has-bled-bleed-stim-meds-y\" value=\"Y\" tabindex=\"16\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n            <div class=\"form-group row\">\r\n                <div class=\"col-sm-8 col-form-label\">\r\n                                    Alcool<br \/>\r\n                    <span class=\"label-lighter\">&ge; 8 unit\u00e9s\/semaine<\/span>\r\n                                <\/div>\r\n                <div class=\"col-sm-4 mt-sm-3\">\r\n                    <div class=\"d-flex btn-group btn-group-toggle\" data-toggle=\"buttons\">\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"alcohol\" id=\"medical-calculator-has-bled-alcohol-n\" value=\"N\" tabindex=\"17\" autocomplete=\"off\">\r\n                                                        Non\r\n                                                    <\/label>\r\n                        <label class=\"btn btn-outline-secondary\">\r\n                            <input type=\"radio\" name=\"alcohol\" id=\"medical-calculator-has-bled-alcohol-y\" value=\"Y\" tabindex=\"18\" autocomplete=\"off\">\r\n                                                        Oui (+1)\r\n                                                    <\/label>\r\n                    <\/div>\r\n                <\/div>\r\n            <\/div>\r\n        <\/form>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12\">\r\n                <div id=\"medical-calculator-has-bled-result-text\" class=\"result-text\">\r\n                    <p><h5>\r\n                                                Score HAS-BLED:\r\n                         <span id=\"medical-calculator-has-bled-result-value\"><\/span><\/h5><\/p>\r\n                    <p id=\"medical-calculator-has-bled-result-interpretation\"><\/p>\r\n                    <p>\r\n                        <ul>\r\n                            <li>\r\n                            <span id=\"medical-calculator-has-bled-result-bleedings-per100y\"><\/span>\r\n                                                            saignements par 100 patients-ann\u00e9es\r\n                                                        <\/li>\r\n                            <li>                            Risque de saignement majeur:\r\n                                                        <span id=\"medical-calculator-has-bled-result-severe-bleedings-risk\"><\/span>\r\n                            <\/li>\r\n                        <\/ul>\r\n                    <\/p>\r\n                    <p>                        Recommandation:\r\n                                        <span id=\"medical-calculator-has-bled-result-recommendation\"><\/span>\r\n                    <\/p>\r\n                <\/div>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12\">\r\n            <p>\r\n                                N = limite sup\u00e9rieure de la norme; ASAT = aspartate aminotransf\u00e9rase; ALAT = alanine aminotransf\u00e9rase; AP = phosphatase alcaline; INR = International Normalized Ratio, AINS = anti-inflammatoire non st\u00e9ro\u00efdien.\r\n                            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12 mt-3\">\r\n                <h5>\r\n                                            Interpr\u00e9tation\r\n                                    <\/h5>\r\n                <div class=\"table-responsive-sm\">\r\n                    <table class=\"table table-bordered\">\r\n                        <thead>\r\n                            <tr>\r\n                                <th>\r\n                                                                            Points\r\n                                                                    <\/th>\r\n                                <th>\r\n                                                                            Saignements par 100 patients-ann\u00e9es <a href=\"#has-bled-cite-note-1\">[1]<\/a>\r\n                                                                    <\/th>\r\n                                <th>\r\n                                                                            Risque de saignement majeur <a href=\"#has-bled-cite-note-3\">[3]<\/a>\r\n                                                                    <\/th>\r\n                                <th>\r\n                                                                            Recommandation\r\n                                                                    <\/th>\r\n                            <\/tr>\r\n                        <\/thead>\r\n                        <tbody>\r\n                            <tr class=\"table-row-a\">\r\n                                <td>\r\n                                                                            0\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            1.13\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            0.9 %\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            <p>Bas risque de saignement majeur<\/p>\r\n                                        <p>Anticoagulation \u00e0 envisager<\/p>\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-b\">\r\n                                <td>\r\n                                                                            1\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            1.02\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            3.4 %\r\n                                                                    <\/td>\r\n                                <td rowspan=\"2\">\r\n                                                                            <p>Risque mod\u00e9r\u00e9 de saignement majeur<\/p>\r\n                                        <p>Anticoagulation envisageable<\/p>\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-c\">\r\n                                <td>\r\n                                                                            2\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            1.88\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            4.1 %\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-d\">\r\n                                <td>\r\n                                                                            3\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            3.74\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            5.8 %\r\n                                                                    <\/td>\r\n                                <td rowspan=\"3\">\r\n                                                                            <p>Haut risque de saignement majeur<\/p>\r\n                                        <p>Prudence avec les anticoagulants<br \/>Envisager des alternatives<\/p>\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-e\">\r\n                                <td>\r\n                                                                            4\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            8.7\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            8.9 %\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-f\">\r\n                                <td>\r\n                                                                            5\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            12.5\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            9.1 %\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                            <tr class=\"table-row-g\">\r\n                                <td>\r\n                                                                            &gt; 5\r\n                                                                        \r\n                                <\/td>\r\n                                <td>\r\n                                                                            -\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            -\r\n                                                                    <\/td>\r\n                                <td>\r\n                                                                            Tr\u00e8s haut risque de saignement majeur\r\n                                                                    <\/td>\r\n                            <\/tr>\r\n                        <\/tbody>\r\n                    <\/table>\r\n                <\/div>\r\n            <\/div>\r\n        <\/div>\r\n\r\n        <div class=\"row\">\r\n            <div class=\"col-sm-12 mt-3\">\r\n                <h5>\r\n                                            R\u00e9f\u00e9rences\r\n                                    <\/h5>\r\n                <ol class=\"references\">\r\n                    <li id=\"has-bled-cite-note-1\">Pisters R, Lane DA, Nieuwlaat R et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-1100<\/li>\r\n                    <li id=\"has-bled-cite-note-2\">Hindricks G, Potpara T, Dagres N et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J 2020:<\/li>\r\n                    <li id=\"has-bled-cite-note-3\">Lip GY, Frison L, Halperin JL et al. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal\/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs\/Alcohol Concomitantly) score. J Am Coll Cardiol 2011; 57: 173-180<\/li>                    \r\n                <\/ol>\r\n            <\/div>\r\n        <\/div>\r\n    <\/div>\r\n    <script type=\"text\/javascript\">\r\n                var medical_calculator_has_bled_messages = {\r\n            'interpretation_0' : 'Bas risque de saignement majeur',\r\n            'interpretation_1-2' : 'Risque mod\u00e9r\u00e9 de saignement majeur',\r\n            'interpretation_3-5' : 'Haut risque de saignement majeur',\r\n            'interpretation_lt5' : 'Tr\u00e8s haut risque de saignement majeur',\r\n            'recommendation_0' : 'Anticoagulation \u00e0 envisager',\r\n            'recommendation_1-2' : 'Anticoagulation envisageable',\r\n            'recommendation_3-5' : 'Prudence avec les anticoagulants. Envisager des alternatives.',\r\n            'recommendation_lt5' : '-',\r\n            'point' : 'point',\r\n            'points' : 'points'\r\n        };\r\n            <\/script>\r\n\n","protected":false},"excerpt":{"rendered":"<p>Le score HAS-BLED \u00e9value le risque de saignement majeur \u00e0 1 an des patients atteints de fibrillation auriculaire et trait\u00e9s par anticoagulants. Exemples de saignement majeur : h\u00e9morragie intracr\u00e2nienne, n\u00e9cessit\u00e9 d\u2019hospitaliser, chute notable de l\u2019h\u00e9moglobine, n\u00e9cessit\u00e9 de transfuser. Le score CHA2DS2-VASc permet d\u2019\u00e9valuer le risque d&rsquo;AVC et de thromboembolie chez les patients avec fibrillation auriculaire.<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":7598,"menu_order":565,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-13826","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/pages\/13826","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/comments?post=13826"}],"version-history":[{"count":2,"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/pages\/13826\/revisions"}],"predecessor-version":[{"id":13828,"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/pages\/13826\/revisions\/13828"}],"up":[{"embeddable":true,"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/pages\/7598"}],"wp:attachment":[{"href":"https:\/\/www.inanutshell.ch\/fr\/wp-json\/wp\/v2\/media?parent=13826"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}