Kinnaird et al identified risk factors for major blood loss and for blood transfusion following a percutaneous coronary intervention (PCI). These can help identify patients who may benefit from more aggressive management. The authors are from Washington Hospital Center (Washington, D.C.), Cardiovascular Research Foundation (NYC) and Rabin Medical Center (Israel).


The TIMI criteria were used to define major and minor bleeding (see Section 06.09.14).


Risk factors for major bleeding:

(1) age > 80 years

(2) use of an intra-aortic balloon pump (IABP)

(3) hypotension during the procedure


The presence a major bleed associated with PCI was associated with an increased risk for in-hospital and 1 year mortality. The occurrence of a stroke had the highest odds ratio for in-hospital and 1 year mortality.


Risk factors for receiving a blood transfusion:

(1) retroperitoneal bleeding

(2) gastrointestinal bleeding (with gross hematemesis, heme-positive coffee ground emesis, or heme-positive melena)

(3) large hematoma (palpable swelling >= 4 cm in diameter) at arterial access site

(4) age > 80 years



• The first 3 items for predicting blood transfusion are the criteria for clinical bleeding.


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