open access

Vol 22, No 6 (2015)
Original articles
Published online: 2015-12-30
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Number of severe bleeding complications according to classification used: Is unified classification of bleeding complications really necessary?

Magdalena Sionova, Peter Blasko, Stepan Jirous, David Vindis, Richard Rokyta, Lenka Posch, Zuzana Motovska
DOI: 10.5603/CJ.a2015.0044
·
Pubmed: 26202655
·
Cardiol J 2015;22(6):665-674.

open access

Vol 22, No 6 (2015)
Original articles
Published online: 2015-12-30

Abstract

Background: To compare the number of severe periprocedural bleeding complications from the total number of bleeding complications associated with diagnostic selective coronary an­giography or percutaneous coronary intervention (PCI) when using different classifications (TIMI, GUSTO, PLATO, BARC) and to relate these classifications to real hemodynamic status of evaluated patients.

Methods: We analyzed data from 106 patients who underwent invasive procedure for ischemic heart disease (selective coronary angiography/PCI) and suffered from any type of bleeding complication.

Results: The number of bleeding according to impacts on hemodynamic status and consequent treatment shows that 54.7% of all bleedings did not need any specific therapy. Bleeding leading to death, hemorrhagic shock, hemodynamic instability, administration of blood transfusion, surgical procedure and local treatment occurred in 6.6%, 1.9%, 5.7%, 14.2%, 2.8%, and 14.2%, respectively. The results comparing bleeding classifications demonstrate that the rate of severe bleeding complications may increase up to 4 times when different classifications are used on the same group of patients (TIMI 9.4%, GUSTO 15.1%, PLATO 39.2% and BARC 35.9%). The power of association between severe bleeding determined by these classifications and real hemodynamic compromise using Kendall’s tau-c correlation is –0.4106 (95% CI –0.599 to –0.222), –0.5355 (95% CI –0.718 to –0.353), –0.5513 (95% CI –0.729 to –0.374) and –0.7552 (95% CI –0.897 to –0.612) for TIMI, GUSTO, PLATO and BARC, respectively.

Conclusions: The data show significant dependence of percentage of severe periprocedural bleeding complications on selected classification. The strongest association between severe bleeding and real hemodynamic status was found for BARC classification as this classification seems to be promising for future general use.

Abstract

Background: To compare the number of severe periprocedural bleeding complications from the total number of bleeding complications associated with diagnostic selective coronary an­giography or percutaneous coronary intervention (PCI) when using different classifications (TIMI, GUSTO, PLATO, BARC) and to relate these classifications to real hemodynamic status of evaluated patients.

Methods: We analyzed data from 106 patients who underwent invasive procedure for ischemic heart disease (selective coronary angiography/PCI) and suffered from any type of bleeding complication.

Results: The number of bleeding according to impacts on hemodynamic status and consequent treatment shows that 54.7% of all bleedings did not need any specific therapy. Bleeding leading to death, hemorrhagic shock, hemodynamic instability, administration of blood transfusion, surgical procedure and local treatment occurred in 6.6%, 1.9%, 5.7%, 14.2%, 2.8%, and 14.2%, respectively. The results comparing bleeding classifications demonstrate that the rate of severe bleeding complications may increase up to 4 times when different classifications are used on the same group of patients (TIMI 9.4%, GUSTO 15.1%, PLATO 39.2% and BARC 35.9%). The power of association between severe bleeding determined by these classifications and real hemodynamic compromise using Kendall’s tau-c correlation is –0.4106 (95% CI –0.599 to –0.222), –0.5355 (95% CI –0.718 to –0.353), –0.5513 (95% CI –0.729 to –0.374) and –0.7552 (95% CI –0.897 to –0.612) for TIMI, GUSTO, PLATO and BARC, respectively.

Conclusions: The data show significant dependence of percentage of severe periprocedural bleeding complications on selected classification. The strongest association between severe bleeding and real hemodynamic status was found for BARC classification as this classification seems to be promising for future general use.

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Keywords

ischemic heart disease, bleeding complications, classification of bleeding

About this article
Title

Number of severe bleeding complications according to classification used: Is unified classification of bleeding complications really necessary?

Journal

Cardiology Journal

Issue

Vol 22, No 6 (2015)

Pages

665-674

Published online

2015-12-30

DOI

10.5603/CJ.a2015.0044

Pubmed

26202655

Bibliographic record

Cardiol J 2015;22(6):665-674.

Keywords

ischemic heart disease
bleeding complications
classification of bleeding

Authors

Magdalena Sionova
Peter Blasko
Stepan Jirous
David Vindis
Richard Rokyta
Lenka Posch
Zuzana Motovska

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