Graafsma et al reported criteria for grading anticoagulant-related bleeding as well as a bleeding severity index. The authors are from the University of Amsterdam and University Hospital Leiden, the Netherlands.
Clinical Findings
Bleeding
no evidence of unusual bleeding
no bleeding
clinically overt bleeding but no criteria for major bleeding met
minor bleeding
one or more criteria for major bleeding (see below)
major bleeding
Criteria for major bleeding - one or more of the following:
(1) fall in hemoglobin by >= 2 g/dL
(2) requiring transfusion of 2 or more units of packed RBCs
(3) retroperitoneal or intracranial bleeding
(4) severe enough to warrant discontinuation of anticoagulant therapy
Bleeding Severity
Therapy
Index
insufficient information to classify
NA
7
no bleeding
none
6
minor
none
5
mild
requires medical examination but no intervention
4
moderate
requires medical examination and intervention but not hospitalized
3
moderate to severe
hospitalized
2
fatal or life-threatening
intensive care
1
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