Bleeding Independently associated with Mortality after noncardiac Surgery (BIMS): an international prospective cohort study establishing diagnostic criteria and prognostic importance

BackgroundWe aimed to establish diagnostic criteria for bleeding independently associated with mortality after noncardiac surgery (BIMS) defined as during or within 30 days that is of surgery, and estimate the proportion 30-day postoperative potentially attributable BIMS.MethodsThis was a prospective cohort study participants ≥45 yr old having inpatient at 12 academic hospitals in eight countries between 2007 2011. Cox proportional hazards models evaluated adjusted relationship candidate BIMS all-cause surgery.ResultsOf 16 079 participants, 2.0% (315) died 36.1% (5810) met predefined screening bleeding. Based on independent association mortality, identified leading haemoglobin <70 g L−1, transfusion ≥1 unit red blood cells, judged be cause death. Bleeding occurred 17.3% patients (2782). Death 5.8% (161/2782), 1.3% (39/3028) who but not criteria, 1.1% (115/10 269) without (adjusted hazard ratio: 1.87; 95% confidence interval: 1.42–2.47). We estimated deaths 20.1–31.9%.ConclusionsBleeding (BIMS), leads transfusion, death, common may account quarter surgery.Clinical trial registrationNCT00512109.