Joseph R. Shaw: Risk Stratification is Only Useful if It is Practical, Consistent, and Easy to Apply at the Bedside
Joseph R. Shaw, Director of Research Program at Ottawa Department of Medicine, EHJ-CVP Associate Editor of European Heart Journal, shared on LinkedIn about a recent article he and his colleagues co-authored, published in JTH, adding:
“Risk stratification is only useful if it is practical, consistent, and easy to apply at the bedside.
In our ISTH SSC guidance document, we propose a revised 3-tier procedural bleed risk framework for anticoagulated patients undergoing planned procedures:
minimal, low/moderate, and high bleed risk.
The goal is to support more consistent perioperative anticoagulation decisions across specialties, while recognizing that the classification is a starting point – not a substitute for clinical judgment.
Patient factors, procedural nuance, local resources, and multidisciplinary input still matter.
I hope this framework helps clinicians, proceduralists, and perioperative teams speak the same language when planning anticoagulant interruption and resumption.
Thanks to Thrombosis Canada and CLOT Conversations for highlighting this work.”
Title: Surgical and procedural bleed risk stratification for anticoagulated patients undergoing planned surgery: guidance from the ISTH SSC Subcommittee on Perioperative and Critical Care Thrombosis and Hemostasis
Authors: Joseph R. Shaw, Jameel Abdulrehman, Steffan Frosi Stella, Grigorios I. Leontiadis, Jan Steffel, Maria P. Ntalouka, Guillaume Martel, Kari A.O. Tikkinen10, Prism Schneider, Mark Turrentine, Achilleas Thoma, Daniel Lee, Adam P.J.J. Bray, Nick Blanas, Edsel Ing, Risa Shorr, Deborah M. Siegal, Jerrold H. Levy, Jean M. Connors, Alex C. Spyropoulos, James Douketis

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