Hemorrhagic transformation, a common complication after reperfusion in AIS, limits therapeutic benefit and worsens outcomes. Although several predictive models exist, none are routinely used in practice. The HAS-BLED score, which estimates bleeding risk in atrial fibrillation, incorporates variables relevant to AIS and may help predict hemorrhagic risk after revascularization.

A total 294 AIS patients were analyzed; 20.1% (n=59) underwent reperfusion therapy (49.2% [n=29] thrombolysis, 33.9% [n=20] thrombectomy, and 16.9% [n=10] both). Half were male, 30.5% had hypertension. Median age was 75 years (IQR 16), and median NIHSS was 10 (IQR 10). Hemorrhagic transformation occurred in 40.7% (n=24). Median HAS-BLED was 2 (IQR 2). In multivariable analysis, HAS-BLED ≥3 was associated with higher odds of hemorrhagic transformation (aOR 2.19; 95% CI 0.59–8.10; p= 0.24), though not significant. Age ≥80 was independently protective (aOR 0.22; 95% CI 0.06–0.84; p= 0.027), and NIHSS >10 showed a borderline association with increased risk (aOR 3.52; 95% CI 0.91–13.62; p = 0.068). Revascularization type and wake-up stroke were not significant predictors.