The International Society of Thrombosis and Hemostasis (ISTH) reported criteria for major bleeding, originally in non-surgical patients.

Features of a major bleed:

(1) life-threatening or fatal

(2) cause chronic sequelae

(3) consume major healthcare resources


Criteria for a major bleed - one or more of the following:

(1) bleeding with fall in hemoglobin >= 2 g/dL

(2) bleeding requiring transfusion >= 2 units of red blood cells

(3) fatal bleed

(4) bleeding into a critical organ


Critical organ bleed:

(1) intracranial

(2) intraspinal

(3) intraocular

(4) retroperitoneal

(5) intra-articular

(6) pericardial

(7) intramuscular with compartment syndrome


A major bleed may require surgical intervention.

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