Table 3.
Comparison of Scoring Systems
The green rows show the scoring system for the Vicenza Bleeding Questionnaire, the blue rows for the Pediatric Bleeding Questionnaire, the white rows for the Condensed MCMDM – 1 VWD bleeding score, and the grey rows show the scoring used for the ISTH-BAT score. [5,7,11,26]
| Score | −1 | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|---|
| Symtpom | ||||||
| Epistaxis | - | No or trivial | Present | Packing, cauterization | Blood transfusion or Replacement therapy | |
| - | No or trivial (≤ 5) | >5 OR more than 10′ | Consultation only | Packing or Cauterization or Antifibrinolytics | Blood transfusion or Replacement therapy or Desmopressin | |
| -- | No or trivial | > 5 or more than 10′ | Consultation only | Packing or cauterization | Blood transfusion or replacement | |
| No/trivial | - > 5/year or more than 10′ | Consultation only | Packing or cauterization or antifibrinolytic | Blood transfusion or replacement therapy (use of hemostatic blood components and rFVIIa) or desmopressin | ||
| Cutaneous | - | No or trivial | Petechiae or bruises | Hematomas | Consultation | |
| No or trivial (< 1cm) | > 1cm AND no trauma | Consultation only | ||||
| -- | No or trivial | > 1 cm and no trauma | Consultation only | -- | -- | |
| No/trivial | For bruises 5 or more (> 1cm) in exposed areas | Consultation only | Extensive | Spontaneous hematoma requiring blood transfusion | ||
| Minor Wounds | - | No or trivial | Present (1–5 episodes/year) | Consultation | Surgical hemostasis | |
| No or trivial (< 5) | > 5 OR more than 5′ | Consultation only or Steri-strips | Surgical hemostasis or Antifibrinolytics | Blood transfusion or Replacement therapy or Desmopressin | ||
| -- | No or trivial | > 5 or more than 5′ | Consultation only | Surgical hemostasis | Blood transfusion or replacement therapy or desmopressin | |
| No/trivial | - > 5/year or more than 10′ | Consultation only | Surgical hemostasis | Blood transfusion, replacement therapy, or desmopressin | ||
| Oral Cavity | - | No or trivial | Present | Consultation only | Surgical hemostasis/Blood transfusion | |
| No | Reported at least one | Consultation only | Surgical hemostasis or Antifibrinolytics | Blood transfusion or Replacement therapy or Desmopressin | ||
| -- | No | Referred at least one | Consultation only | Surgical hemostasis or antifibrinolytic | Blood transfusion or replacement therapy or desmopressin | |
| No/trivial | Present | Consultation only | Surgical hemostasis or antifibrinolytic | Blood transfusion, replacement therapy or desmopressin | ||
| Menorrhagia | - | No or trivial | Present | Consultation, pill use, iron therapy | Blood transfusion, hysterectomy, D&C | |
| No | Reported or consultation only | Antifibrinolytics or Pill use | D&C, Iron therapy | Blood transfusion or Replacement therapy or Desmopressin or Hysterectomy | ||
| -- | No | Consultation only | Antifibrinolytics, pill use | Dilation & curettage, iron therapy, ablation | Blood transfusion or replacement therapy or desmopressin or hysterectomy | |
| 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 | - | No or trivial | Present, iron therapy | Blood transfusion, D&C, suturing | Hysterectomy | |
| no bleeding in at least 2 deliveries | No deliveries or no bleeding in 1 delivery | Reported or consultation only | D&C, Iron therapy, Antifibrinolytics | Blood transfusion or Replacement therapy or Desmopressin | Hysterectomy | |
| No bleeding in at least 2 deliveries | None done or no bleeding in 1 delivery | Consultation only | Dilation & curettage, iron therapy, antifibrinolytics | Blood transfusion or replacement therapy or desmopressin | Hysterectomy | |
| 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 hematoma | - | No or trivial | Present | Consultation only | Blood transfusion, surgery | |
| 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 | ||
| 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 | ||
| 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 | ||
| Gastrointestinal tract | - | No or trivial | Present | Consultation only | Surgery/Blood transfusion | - |
| No | Identified cause | Consultation or Spontaneous | Surgical hemostasis, Antifibrin., Blood transf., Replacement therapy, Desmopressin | |||
| -- | No | Associated with ulcer, portal hypertension, hemorrhoids, angiodysplasia | Spontaneous | Surgical hemostasis, blood transfusion, replacement therapy, desmopressin, antifibrinolytic | -- | |
| No/trivial | Present (not associated with ulcer, portal hypertension, hemorrhoids, angiodysplasia) | Consultation only* | Surgical hemostasis, antifibrinolytic | Blood transfusion, replacement therapy or desmopressin | ||
| Hematuria | ||||||
| No/trivial | Present (macroscopic) | Consultation only* | Surgical hemostasis, | Blood transfusion, replacement therapy or desmopressin | ||
| Tooth extraction | - | No or trivial | Present | Suturing or packing | Blood transfusion | |
| No bleeding in at least 2 extractions | None done or no bleeding in 1 | Reported, no consultation | Consultation only | Resuturing, Repacking or Antifibrinolytics | Blood transfusion or Replacement therapy or Desmopressin | |
| No bleeding in at least 2 extractions | None done or no bleeding in 1 extraction | Reported, no consultation * | Consultation only | Resuturing or packing | Blood transfusion or replacement therapy or desmopressin | |
| 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 or trivial | Present | Suturing or resurgery | Blood transfusion | |
| No bleeding in at least 2 surgeries | None done or no bleeding in 1 | Reported, no consultation | Consultation only | Surgical hemostasis or Antifibrinolytic | Blood transfusion or Replacement therapy or Desmopressin | |
| No bleeding in at least 2 surgeries | None done or no bleeding in 1 surgery | Reported, no consultation | Consultation only | Surgical hemostasis or antifibrinolytic | Blood transfusion or replacement therapy or desmopressin | |
| 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 | ||
| Hemarthrosis | - | No or trivial | Present | Consultation only | Blood transfusion, surgery | - |
| 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 | ||
| 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 | ||
| 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 | ||
| Central nervous system | ||||||
| Never | - | - | Subdural, any intervention | Intracerebral, any intervention | ||
| Never | - | - | Subdural, any intervention | Intracerebral, any intervention | ||
| Never | - | - | Subdural, any intervention | Intracerebral, any intervention | ||
| Other Bleedings | ||||||
| No | Reported | Consultation only | Surgical hemostasis, Antifibrinolytics, Iron therapy | Blood transfusion or Replacement therapy or Desmopressin | ||
| No/trivial | Present | Consultation only* | Surgical hemostasis, antifibrinolytics | Blood transfusion or replacement therapy or desmopressin |