Franco et al evaluated bleeding in patients being treated with anticoagulants. They proposed a prognostic classification and compared it to that of the International Society of Thrombosis and Haemostasis (ISTH). The authors are from multiple institutions in Italy and Germany.
Patient selection: bleeding while on an oral anticoagulant
Outcome: life-threatening with risk of 30-day mortality
Criteria for life-threatening bleed (Grade III):
(1) intracerebral hemorrhage AND Glasgow coma score < 14
(2) non-intracerebral hemorrhage AND shock or hypotension
(3) non-intracerebral hemorrhage AND pericardial bleeding
Criteria for severe bleed (Grade II):
(1) intracerebral hemorrhage AND Glasgow coma score 14 or 15
(2) non-intracerebral hemorrhage AND major bleeding (see below) AND NOT hypotensive
where:
• Major bleeding criteria of the ISTH not covered by other Grades include: (1) fall in hemoglobin >= 2 g/dL; (2) transfusion of >= 2 units of packed red blood cells; or(3) bleeding into a critical location (spinal, intramuscular with compartment syndrome, retroperitoneal)
Criteria for serious bleed (Grade I):
(1) intra-articular
(2) intra-ocular
