//fpnotebook.com/
ISTH Bleeding Assessment Tool
Aka: ISTH Bleeding Assessment Tool, ISTH-BAT, International Society of Thrombosis and Hemostasis BAT
- See Also
- Bleeding Disorder
- Indications
- Screening for congenital Bleeding Disorders
- Precautions
- Test Sensitivity and Test Specificity are poor for inherited Platelet function disorders
- Lowe (2013) J Thromb Haemost 11(9): 1663-8 [PubMed]
- Criteria
- Epistaxis
- Score 0: None or Trivial
- Score 1: More than 5 per year, or lasting >10 minutes
- Score 2: Consultation Only
- Score 3: Treated with packing, cauterization or antifibrinolytics
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Cutaneous symptoms
- Score 0: None or Trivial
- Score 1: Five or more Bruises, each >1 cm, in exposed areas
- Score 2: Consultation Only
- Score 3: Extensive
- Score 4: Spontaneous hematoma requiring Blood Transfusion
- Bleeding from minor wounds
- Score 0: None or Trivial
- Score 1: More than 5 per year, or lasting >10 minutes
- Score 2: Consultation Only
- Score 3: Surgical Hemostasis
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Oral cavity symptoms
- Score 0: None or Trivial
- Score 1: Present
- Score 2: Consultation Only
- Score 3: Surgical Hemostasis or antifibrinolytics
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Gastrointestinal Bleeding
- Score 0: None or Trivial
- Score 1: Present (but not associated with ulcer, Portal Hypertension, Hemorrhoids or Angiodysplasia)
- Score 2: Consultation Only
- Score 3: Surgical Hemostasis or antifibrinolytics
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Hematuria
- Score 0: None or Trivial
- Score 1: Present
- Score 2: Consultation Only
- Score 3: Surgical Hemostasis or iron therapy
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Tooth Extraction
- Score 0: None or Trivial
- Score 1: Bleeding reported in <25% of patient's procedures (but no intervention needed)
- Score 2: Bleeding reported in >25% of patient's procedures (but no intervention needed)
- Score 3: Resuturing or packing required
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Surgery
- Score 0: None or Trivial
- Score 1: Bleeding reported in <25% of patient's procedures (but no intervention needed)
- Score 2: Bleeding reported in >25% of patient's procedures (but no intervention needed)
- Score 3: Surgical Hemostasis or antifibrinolytics
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Menorrhagia
- Score 0: None or Trivial
- Score 1: Consultation only (changed pads more than q2h, clotting or flooding, or score >100 on pictorial blood loss)
- Score 2: Work or school missed more than twice yearly due to bleeding. Treated with antifibrinolytic or iron therapy
- Score 3: Treated with both antifibrinolytic and hormon therapy OR Menorrhagia since Menarche and duration >12 months
- Score 4: Acute with hospitalization, Blood Transfusion, replacement, Desmopressin, and D&C, ablation or Hysterectomy
- Postpartum Hemorrhage
- Score 0: None or Trivial
- Score 1: Consultation only, treated with Pitocin, lochia persisted >6 weeks
- Score 2: Treated with antifibrinolytic or iron therapy
- Score 3: Treated with Blood Transfusion or other replacement, Desmopressin, exam under Anesthesia, uterine balloon
- Score 4: Required Critical Care or surgery (Hysterectomy, iliac artery ligation, uterine artery embolization, uterine brace)
- Muscle Hematomas
- Score 0: Never
- Score 1: Post-Trauma and no treatment required
- Score 2: Spontaneous onset and no treatment required
- Score 3: Spontaneous or Traumatic, but required Desmopressin or replacement therapy
- Score 4: Spontaneous or Traumatic, but required Blood Transfusion or surgical intervention
- Hemarthrosis
- Score 0: Never
- Score 1: Post-Trauma and no treatment required
- Score 2: Spontaneous onset and no treatment required
- Score 3: Spontaneous or Traumatic, but required Desmopressin or replacement therapy
- Score 4: Spontaneous or Traumatic, but required Blood Transfusion or surgical intervention
- Central Nervous System Bleeding
- Score 0: Never
- Score 3: Subdural Hematoma, any intervention
- Score 4: Intracerebral, any intervention
- Other Bleeding (e.g. umbilical stump bleeding, Cephalohematoma, Conjunctival Hemorrhage, excessive bleeding after venipuncture)
- Score 0: None or Trivial
- Score 1: Present
- Score 2: Consultation only
- Score 3: Surgical Hemostasis or antifibrinolytics
- Score 4: Blood Transfusion, replacement (e.g. Factor VIIa, PCC4), Desmopressin
- Interpretation
- Abnormal cut-offs
- Men >3
- Women >5
- Children >2
- References
- Elbatarny (2014) Haemophilia 20(6): 831-5 +PMID:25196510 [PubMed]
- Resources
- ISTH-BAT PDF full documentation
- https://c.ymcdn.com/sites/www.isth.org/resource/resmgr/ssc/isth-ssc_bleeding_assessment.pdf
- References
- Neutze (2016) Am Fam Physician 93(4): 279-86 [PubMed]
- Rodeghhiero (2010) J Thromb Haemost 8(9): 2063-5 [PubMed]