Bleeding Academic Research Consortium

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

In order to harmonize and create a universal definition of bleeding, the Bleeding Academic Research Consortium (BARC) was convened. Dr. C Michael Gibson chaired the subcommittee drafting the definition of bleeding types 0, 1 and 2; Dr. Gabriel Stegg chaired the subcommittee drafting the definition of bleeding types 3a and 3b; Dr. Harvey White chaired the subcommittee drafting the definitions of coronary artery bypass grafting bleeding; and Dr. Deepak Bhatt chaired the subcommittee on fatal bleeding. The committee was chaired by Dr. Roxana Mehran and Dr. Sunil Rao.

BARC Definition (DO NOT EDIT)

Bleeding Academic Research Consortium (BARC) definition for Bleeding: ^[1]

“

Type 0:

No bleeding

Type 1:

Bleeding that is not actionable and does not cause the patient to seek unscheduled performance of studies, hospitalization, or treatment by a health-care professional; may include episodes leading to self-discontinuation of medical therapy by the patient without consulting a health-care professional.

Type 2:

Any overt, actionable sign of hemorrhage (e.g., more bleeding than would be expected for a clinical circumstance, including bleeding found by imaging alone) that does not fit the criteria for type 3, 4, or 5 but does meet at least one of the following criteria:

requiring nonsurgical, medical intervention by a health-care professional,
leading to hospitalization or increased level of care, or
prompting evaluation

Type 3:

Type 3a:

Overt bleeding plus hemoglobin drop of 3 to < 5 g/dL* (provided hemoglobin drop is related to bleed)
Any transfusion with overt bleeding

Type 3b:

Overt bleeding plus hemoglobin drop ≥5 g/dL* (provided hemoglobin drop is related to bleed),
Cardiac tamponade,
Bleeding requiring surgical intervention for control (excluding dental/nasal/skin/hemorrhoid),
Bleeding requiring intravenous vasoactive agents

Type 3c:

Intracranial hemorrhage (does not include microbleeds or hemorrhagic transformation, does include intraspinal),
Subcategories confirmed by autopsy or imaging or lumbar puncture,
Intraocular bleed compromising vision.

Type 4:

CABG-related bleeding,
Perioperative intracranial bleeding within 48 h,
Reoperation after closure of sternotomy for the purpose of controlling bleeding
Transfusion of ≥ 5 U whole blood or packed red blood cells within a 48-h period,
Chest tube output more than or equal to 2L within a 24-h period

Type 5:

Fatal bleeding

Type 5a:

Probable fatal bleeding; no autopsy or imaging confirmation but clinically suspicious

Type 5b:

Definite fatal bleeding; overt bleeding or autopsy or imaging confirmation

”

References

↑ Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J; et al. (2011). “Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the bleeding academic research consortium”. Circulation. 123 (23): 2736–47. doi:10.1161/CIRCULATIONAHA.110.009449. PMID 21670242.

Template:WH Template:WS CME Category::Cardiology

[pmid21670242-1] Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J; et al. (2011). “Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the bleeding academic research consortium”. Circulation. 123 (23): 2736–47. doi:10.1161/CIRCULATIONAHA.110.009449. PMID 21670242.

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