LAUSR

Perioperative bleeding following cardiac surgery predisposes to poor outcomes by incurring an elevated susceptibility to infection and organ injury (renal insult, myocardial injury, transfusion-associated lung injury, and stroke), intricately affecting the length of intensive care unit (ICU) and hospital stay and the associated morbidity-mortality[1]. Albeit a considerable clinical impact, sound risk-stratification of the complication is largely precluded by the heterogeneity of the bleeding classifications and the subsequent validity in predicting patient outcomes. A variety of bleeding classifications have been proposed and evaluated in cardiovascular clinical trials with the majority of the literature emanating from the setting of acute coronary syndromes (ACS). There is a recent clinical interest to evaluate the prognostic significance of different bleeding definitions in patients undergoing coronary artery bypass grafting (CABG) considering the sizeable frequency of ACS patients (nearly 12%) undergoing surgical revascularization during index hospitalization, predisposed patient cohort (comorbid status and preoperative anticoagulant therapy), and the need to tenuously balance the risk of perioperative bleeding and thrombosis[2]. The recent inclusion of CABG-related bleeding (Type-4) in the Bleeding Academic Research Consortium (BARC) 2011 consensus document[2] bears testimony to the aforementioned fact (Table 1). Dyke et al.[3] proposed a Universal Definition of Perioperative Bleeding (UDPB) stratifying perioperative bleeding risk (0: insignificant; 1: mild; 2: moderate; 3: severe; 4: massive) based Braz J Cardiovasc Surg 2020;35(3):409-10