From clinical trials | From guidelines | |||
---|---|---|---|---|
BARC [66] | TIMI [39] | GUSTO [40] | ESC/EACTS 2017 [1] | |
Type 1: Bleeding that is not actionable and does not cause the patient to seek unscheduled performance of studies, hospitalization, or treatment by healthcare professional | Minimal: Any overt bleeding event that does not meet below criteria | Mild: Bleeding that does not meet below criteria | Trivial bleeding: Any bleeding not requiring medical intervention or further evaluation | e.g., skin bruising or ecchymosis, self-resolving epistaxis, minimal conjunctival bleeding |
Type 2: Any overt, actionable sign of hemorrhage that does not fit the criteria for type 3, 4, or 5, but does meet at least one of the following criteria: (1) requiring non-surgical medical intervention by a healthcare professional, (2) leading to hospitalization or increased level of care, or (3) prompting evaluation | Minor: Clinically overt bleeding resulting in Hb drop of 3Â g/dL to <5Â g/dL | Moderate: Bleeding requiring blood transfusion but not resulting in hemodynamic instability | Mild bleeding: Any bleeding that requires medical attention without requiring hospitalization | e.g., not self-resolving epistaxis, moderate conjunctival bleeding, genitourinary or upper/lower GI bleeding without significant blood loss, mild hemoptysis |
Type 3 3a: Overt bleeding plus Hb drop of 3 g/dL to <5 g/dL or any transfusion with overt bleeding 3b: Overt bleeding plus Hb drop ≥5 g/dL, cardiac tamponade, bleeding requiring survival intervention for control or bleeding requiring intravenous vasoactive agents 3c: Intracranial hemorrhage or intraocular bleed compromising vision | Major: Fatal bleeding, intracranial bleeding or clinically overt signs of bleeding associated with a drop in Hb of ≥5 g/dL | Severe or life-threatening: Intracranial hemorrhage or bleeding resulting in substantial hemodynamic compromise requiring treatment | Moderate bleeding: Any bleeding associated with a significant blood loss (>3 g/dL Hb) and/or requiring hospitalization, which is hemodynamically stable and not rapidly evolving | e.g., genitourinary, respiratory or upper/lower GI bleeding with significant blood loss or requiring transfusion |
Type 4: CABG-related bleeding, including perioperative intracranial bleeding with 48 h, reoperation after closure of sternotomy for the purpose of controlling bleeding, transfusion of ≥5 units of whole blood or packed red blood cells within a 48 h period, chest tube output ≥2 L within a 24 h period |  |  | Severe bleeding: Any bleeding requiring hospitalization, associated with a severe blood loss (>3 g/dL Hb) that is hemodynamically stable and not rapidly evolving | e.g., severe genitourinary, respiratory or upper/lower GI bleeding |
Type 5: Fatal bleeding 5a: Probable fatal bleeding, no autopsy or imaging confirmation but clinically suspicious 5b: Define fatal bleeding, overt bleeding, or autopsy or imaging confirmation |  |  | Life-threatening bleeding: Any severe active bleeding putting patient’s life immediately at risk | e.g., massive overt genitourinary, respiratory or upper/lower GI bleeding, active intracranial, spinal or intraocular hemorrhage, or any bleeding causing hemodynamic instability |