HAS-BLED Score and Bleeding Risk in RC: Dataset

Objective To evaluate the predictive value of the preoperative HAS-BLED score in estimating clinically significant blood loss in the course of radical cystectomy (RC). Materials and Methods We retrospectively reviewed 176 patients who underwent RC. Major hemorrhage was defined as a change in hemoglobin level (delta hemoglobin = preoperative hemoglobin level – postoperative hemoglobin level) of ≥4 g/dL, the need for blood transfusion to manage bleeding, or the necessity of early reintervention due to postoperative hemorrhage or related complications within 14 days. HAS-BLED scores were calculated preoperatively. Univariable and multivariable logistic regression analyses were performed to identify independent predictors. ROC analysis was used to assess the discriminative ability of the HAS-BLED score. Results Major postoperative bleeding occurred in 22 patients (12.5%). Bleeding patients had significantly higher HAS-BLED scores compared to those without bleeding (p < 0.001). Each 1-point increase in the HAS-BLED score tripled the odds of bleeding (OR: 3.01, 95% CI: 1.83–4.93). Multivariable analysis identified hypertension, renal or hepatic dysfunction, and history of stroke as independent risk factors. ROC analysis showed an AUC of 0.796, and the Youden-optimal cut-off was 2.5, corresponding to a clinical threshold of ≥3. In a subgroup of patients on anticoagulants (n = 35), 40% experienced bleeding, and HAS-BLED remained predictive (OR: 2.02, p = 0.045). Conclusion The HAS-BLED score effectively predicts clinically meaningful bleeding after RC and may aid in preoperative risk stratification. A threshold of ≥3 appears suitable for identifying high-risk patients, particularly in those on anticoagulant therapy.