Cardiac catheterization with thrombolysis, anticoagulation and/or use of antiplatelet agents may be associated with bleeding as a complication.
TIMI (Thrombolysis in Myocardial Infarction) classification:
(1) major bleeding
(2) minor bleeding
|
Bleeding Manifestation
|
Classification
|
|
drop in hemoglobin > 5 g/dL
|
major
|
|
intracranial hemorrhage (stroke)
|
major
|
|
drop in hemoglobin from 3-5 g/dL with known bleeding site
|
minor
|
|
drop in hemoglobin < 3 g/dL with gross hematuria, hematemesis, and/or hemoptysis
|
minor
|
where:
• The interpretation gets difficult if the person has bleeding at other sites unrelated to the cardiac catheterization..
• A drop in hemoglobin > 5 g/dL is approximately equivalent to a drop in the hematocrit > 15 percent.
Additional bleeding criteria:
(1) hematoma at arteriotomy site (definition varies with study. as shown in Table 3 in Resnice et al; Exaire et al used > 5 cm)
(2) significant rebleeding after initial hemostasis
(3) bleeding associated with a delay in hospital discharge
(4) bleeding requiring transfusion
(5) retroperitoneal hematoma
