WILL-BLEED (CABG Perioperative Bleeding) Calculator

Heads-up: You asked for the “CARDEL Index (CABG perioperative bleeding)”. The CARDEL Index predicts postoperative delirium after CABG, not bleeding. For perioperative bleeding after isolated CABG, the validated model is the WILL-BLEED Risk Score (Biancari et al., Thromb Haemost 2017). The tool below implements that score using the original logistic model coefficients for a more precise probability estimate, alongside the published integer score and risk groups.

Sex
Hemoglobin (g/dL) Preoperative anemia = Hb < 12.0 g/dL (women) or < 13.0 g/dL (men).
eGFR (mL/min/1.73 m²) Risk threshold: eGFR < 45 mL/min/1.73 m².
Acute Coronary Syndrome (ACS)
Potent P2Y12 inhibitor paused < 5 days pre-op
Heparin / Anticoagulant in pre-op period
Critical Preoperative State (any of the following)
VT/VF or aborted sudden death
Pre-op CPR
Pre-op mechanical ventilation
Pre-op inotropes or IABP
Acute renal failure (oliguria < 10 mL/hr)

WILL-BLEED Risk Score for CABG: Explanation and Clinical Context
The WILL-BLEED Score predicts severe perioperative bleeding after isolated CABG, defined as E-CABG bleeding grades 2–3 (transfusion of >4 RBC units and/or reoperation for bleeding). Predictors include anemia, female sex, eGFR <45, ACS, recent P2Y12 inhibition, pre-op anticoagulant use, and critical pre-op state. Each variable contributes to both the integer score and logistic model probability.

Risk interpretation: Score 0–3 = ~3%, 4–6 = ~7%, >6 = ~24% risk of severe bleeding. The logistic probability provides a continuous estimate of individualized risk.

Reference:
Biancari F, et al. Thromb Haemost. 2017;117(3):445–456. doi:10.1160/TH16-09-0721.
Salsano A, et al. Perfusion. 2020.

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