ISTH Bleeding Assessment Tool - Hematologie Groningen

Hematologie Groningen

Deze site is een initiatief van de afdeling Hematologie van het Universitair Medisch Centrum Groningen en is tot stand gekomen met steun van het IKN en afdeling Interne Geneeskunde van het UMCG.

SYMPTOMS (up to the time of diagnosis)	0^§	1^§	2	3	4
Epistaxis	No/trivial	– > 5/year or – more than 10 minutes	Consultation only^*	Packing or cauterization or antifibrinolytic	Blood transfusion or replacement therapy (use of hemostatic blood components and rFVIIa) or desmopressin
Cutaneous	No/trivial	For bruises 5 or more (> 1cm) in exposed areas	Consultation only^*	Extensive	Spontaneous hematoma requiring blood transfusion
Bleeding from minor wounds	No/trivial	– > 5/year or – more than 10 minutes	Consultation only^*	Surgical hemostasis	Blood transfusion, replacement therapy or desmopressin
Oral cavity	No/trivial	Present	Consultation only^*	Surgical hemostasis or antifibrinolytic	Blood transfusion, replacement therapy or desmopressin
GI bleeding	No/trivial	Present (not associated with ulcer, portal hypertension, hemorrhoids, angiodysplasia)	Consultation only^*	Surgical hemostasis or antifibrinolytic	Blood transfusion, replacement therapy or desmopressin
Hematuria	No/trivial	Present (macroscopic)	Consultation only^*	Surgical hemostasis, iron therapy	Blood transfusion, replacement therapy or desmopressin
Tooth extraction	No/trivial or none done	Reported in ≤ 25% of all procedures, no intervention^**	Reported in > 25% of all procedures, no intervention^**	Resuturing or packing	Blood transfusion, replacement therapy or desmopressin
Surgery	No/trivial or none done	Reported in ≤ 25% of all procedures, no intervention^**	Reported in > 25% of all procedures, no intervention^**	Surgical hemostasis or antifibrinolytic	Blood transfusion, replacement therapy or desmopressin
Menorrhagia	No/trivial	Consultation only^* or – Changing pads more frequently than every 2 hours or – Clot and flooding or – PBAC score > 100^#	– Time off work/school > 2/year or – Requiring antifibrinolytics or hormonal or iron therapy	– Requiring combined treatment with antifibrinolytics and hormonal therapy or – Present since menarche and > 12 months	– Acute menorrhagia requiring hospital admission and emergency treatment or – Requiring blood transfusion, Replacement therapy, Desmopressin, or – Requiring dilatation & curretage or endometrial ablation or hysterectomy
Post-partum hemorrhage	No/trivial or no deliveries	Consultation only^* or – Use of syntocin or – Lochia > 6 weeks	– Iron therapy or – Antifibrinolytics	– Requiring blood transfusion, replacement therapy, desmopressin or – Requiring examination under anaesthesia and/or the use of uterin balloon/package to tamponade the uterus	Any procedure requiring critical care or surgical intervention (e.g. hysterectomy, internal iliac artery legation, uterine artery embolization, uterine brace sutures)
Muscle hematomas	Never	Post trauma, no therapy	Spontaneous, no therapy	Spontaneous or traumatic, requiring desmopressin or replacement therapy	Spontaneous or traumatic, requiring surgical intervention or blood transfusion
Hemarthrosis	Never	Post trauma, no therapy	Spontaneous, no therapy	Spontaneous or traumatic, requiring desmopressin or replacement therapy	Spontaneous or traumatic, requiring surgical intervention or blood transfusion
CNS bleeding	Never			Subdural, any intervention	Intracerebral, any intervention
Other bleedings^{^}	No/trivial	Present	Consultation only^*	Surgical hemostasis, antifibrinolytics	Blood transfusion or replacement therapy or desmopressin
Score