Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
in order to harmonize and create a universal definition of bleeding, the Bleeding Academic Research Consortium (BARC) was convened. Dr. C Michael Gibson chaired the subcommittee drafting the definition of bleeding types 0, 1 and 2; Dr. Gabriel Stegg chaired the subcommittee drafting the definition of bleeding types 3a and 3b; Dr. Harvey White chaired the subcommittee drafting the definitions of coronary artery bypass grafting bleeding; and Dr. Deepak Bhatt chaired the subcommittee on fetal bleeding.
Definitions
Bleeding Academic Research Consortium (BARC) definition for Bleeding (DONOT EDIT)[1]
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- Type 1: bleeding that is not actionable and does not cause the patient to seek unscheduled performance of studies, hospitalization, or treatment by a health-care professional; may include episodes leading to self-discontinuation of medical therapy by the patient without consulting a health-care professional.
- Type 2: any overt, actionable sign of hemorrhage (eg, more bleeding than would be expected for a clinical circumstance, including bleeding found by imaging alone) that does not fit the criteria for type 3, 4, or 5 but does meet at least one of the following criteria: (1) requiring nonsurgical, medical intervention by a health-care professional, (2) leading to hospitalization or increased level of care, or (3) prompting evaluation
- Type 3
- Type 3a'
- Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL* (provided hemoglobin drop is related to bleed)Any transfusion with overt bleeding
- Type 3b'
- Overt bleeding plus hemoglobin drop ≥5 g/dL* (provided hemoglobin drop is related to bleed)Cardiac tamponade, Bleeding requiring surgical intervention for control (excludingdental/nasal/skin/hemorrhoid), Bleeding requiring intravenous vasoactive agents
- Type 3c'
- Intracranial hemorrhage (does not include microbleeds or hemorrhagic transformation, does include intraspinal), Subcategories confirmed by autopsy or imaging or lumbar puncture, Intraocular bleed compromising vision.
- Type 4: CABG-related bleeding, Perioperative intracranial bleeding within 48 h, Reoperation after closure of sternotomy for the purpose of controlling bleeding
Transfusion of ≥ 5 U whole blood or packed red blood cells within a 48-h period, Chest tube output more than or equal to 2L within a 24-h period
- Type 5: fatal bleeding
- Type 5a'
- Probable fatal bleeding; no autopsy or imaging confirmation but clinically suspicious
- Type 5b'
- Definite fatal bleeding; overt bleeding or autopsy or imaging confirmation
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References
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