Assessing  Bleeding – Surgical risk

 

It is difficult to categorise surgical procedures into different bleeding risk groups. The ideal  assessment should be made by the surgeon performing the procedure, however when planning the need for bridging therapy and which treatment to use it is helpful to be able to make some assessment of the surgical bleeding risk.

 

The stratification we have used in this application place procedures into 3 groups.

Low risk  - Minor procedures that can be managed with no interruption of warfarin or brief cessation for 2 or 3 days

Standard risk – Most surgical procedures

High risk – Procedures with a high risk of bleeding.

 

High Risk of Bleeding

The latest American College of Chest Physician Guidelines list the following as high risk cases

 

Urological Surgery

Pacemaker or implantable defibrillator

Colonic polyp resection

Surgery in vascular organs

Bowel resection

Major surgery with extensive tissue injury

Cardic surgery

Neurosurgery

 

Low Risk of Bleeding

The guidelines suggest that the following procedures are low risk.

 

Minor dental procedures including dental extraction

Minor skin procedures

Cataracts