Table 2.

ISTH Bleeding Assessment Tool (BAT)

	Score
Symptoms (Up to Time of Diagnosis)	0§	1§	2	3	4
Epistaxis	No/trivial	>5/year or >10 minutes	Consultation only*	Packing/cauterization or antifibrinolytic	Blood transfusion, replacement therapy^^ or desmopressin
Cutaneous	No/trivial	≥5 bruises of >1 cm in exposed areas	Consultation only*	Extensive	Spontaneous haematoma requiring blood transfusion
Bleeding from minor wounds	No/trivial	>5/year or >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
Gastro intestinal bleeding	No/trivial	Present (not associated with ulcer, portal hypertension, hemorrhoids, angiodysplasia)	Consultation only*	Surgical hemostasis or antifibrinolytic	Blood transfusion, replacement therapy^^ or desmopressin
Hematura	No/trivial	Present (macroscopic)	Consultation only*	Surgical hemostasis, iron therapy	Blood transfusion, replacement therapy^^ or desmopressin
Tooth extraction	No/trivial or none done	≤25% of all procedures, no intervention**	>25% of all procedures, no intervention**	Resuturing or packing	Blood transfusion, replacement therapy^^ or desmopressin
Surgery	No/trivial or none done	≤25% of all procedures, no intervention**	>25% of all procedures, no intervention**	Surgical hemostasis or antifibrinolytic	Blood transfusion, replacement therapy^^ or desmopressin
Menorrhagia	No/trivial	Consultation only* or Changing pads > every 2 hours or Clot and flooding or PBAC score >100#	Time off work/school >2/year or Antifibrinolytics/hormonal/iron therapy	Combined treatment with antifibrinolytics and hormonal therapy or Present since menarche and >12 months	Acute menorrhagia requiring hospital admission and emergency treatment or Blood transfusion, replacement therapy^^ or desmopressin or Dilatation and curettage 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	Blood transfusion, replacement therapy^^ or desmopressin or Examination under anaesthesia and/or uterine balloon/package to tamponade uterus	Any procedure requiring critical care or surgical intervention (eg hysterectomy, internal iliac artery legation, uterine artery embolization, uterine brace sutures)
Muscle haematomas	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 bleeding^	No/trivial	Present	Consultation only*	Surgical hemostasis, antifibrinolytics	Blood transfusion or replacement therapy^^ or desmopressin

Notes: In addition to the guidance offered by the table, it is mandatory to refer to the text for more detailed instructions. ^§Distinction between 0 and 1 is of critical importance. Score 1 means that the symptom is judged as present in the patient’s history by the interviewer but does not qualify for a score 2 or more. *Consultation only: the patient sought medical evaluation and was either referred to a specialist or offered detailed laboratory investigation. **Example: 1 extraction/surgery resulting in bleeding (100%): the score to be assigned is 2; 2 extractions/surgeries, 1 resulting in bleeding (50%): the score to be assigned is 2; 3 extractions/surgeries, 1 resulting in bleeding (33%): the score to be assigned is 2; 4 extractions/surgeries, 1 resulting in bleeding (25%): the score to be assigned is 1. ^#If already available at the time of collection. ^{^}Include: umbilical stump bleeding, cephalohematoma, cheek hematoma caused by sucking during breast/bottle feeding, conjunctival hemorrhage or excessive bleeding following circumcision or venipuncture. Their presence in infancy requires detailed investigation independently from the overall score. ^{^^}Use of hemostatic blood components and rFVIIa. Reproduced from Rodeghiero F, Tosetto A, Abshire T, Arnold DM, Coller B, James P, Neunert C, Lillicrap D; ISTH/SSC joint VWF and Perinatal/Pediatric Hemostasis Subcommittees Working Group. ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. J Thromb Haemost. 2010;8(9):2063–2065. © 2010 International Society on Thrombosis and Haemostasis.¹³