ISTH SSC Bleeding Assessment Tool Calculator
ISTH SSC STANDARDIZED BLEEDING ASSESSMENT
ISTH SSC Bleeding Assessment Tool
A standardized bleeding questionnaire used to quantify bleeding symptoms in patients being evaluated for inherited bleeding disorders.
14
Bleeding domains
The assessment covers common mucocutaneous, surgical, obstetric, musculoskeletal, and central nervous system bleeding manifestations.
0 to 4
Domain score
Most domains are scored from 0 to 4 according to severity and the treatment required.
0 to 56
Maximum theoretical score
The total score is calculated by adding the selected scores from all applicable domains.
About the ISTH SSC Bleeding Assessment Tool
The ISTH SSC Bleeding Assessment Tool was developed by the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis to provide a standardized method for assessing bleeding symptoms in patients with suspected inherited bleeding disorders.
The score is calculated by adding the selected points from each bleeding domain. The severity of bleeding is determined not only by the presence of symptoms, but also by the clinical intervention or treatment required.
Important scoring principle
Symptoms and treatment occurring before or at the time of diagnosis should be considered. The distinction between score 0 and score 1 is important. A score of 1 indicates that the symptom is considered present by the interviewer but does not fulfill the criteria for a higher score.
Meaning of consultation only
Consultation only means that the patient sought medical evaluation and was referred to a specialist or was offered detailed laboratory investigation because of the bleeding symptom.
Tooth extraction and surgery
For procedures such as tooth extraction and surgery, the proportion of procedures associated with abnormal bleeding is relevant. For example, 1 of 1 procedure corresponds to 100 percent and qualifies for score 2. One of 2 corresponds to 50 percent and qualifies for score 2. One of 3 corresponds to approximately 33 percent and qualifies for score 2. One of 4 corresponds to 25 percent and qualifies for score 1.
PBAC consideration
A Pictorial Blood Assessment Chart score greater than 100 may support a score of 1 for menorrhagia when the PBAC result was already available at the time of assessment.
Clinical interpretation
In adult males, a total score from 0 to 3 is within the typical range, while a score of 4 or higher is considered atypical.
In adult females, a total score from 0 to 5 is within the typical range, while a score of 6 or higher is considered atypical.
In children younger than 18 years, a total score from 0 to 2 is within the typical range, while a score of 3 or higher is considered atypical.
Clinical use
The ISTH BAT is a structured bleeding history tool and should not be used as a standalone diagnostic test. An atypical score may support further evaluation for an inherited bleeding disorder, but interpretation should consider the clinical context, age, sex, medication exposure, comorbid conditions, and laboratory findings.
Important limitation
This calculator reproduces the published scoring framework for educational and clinical decision support purposes. It does not replace clinical judgment, hematology consultation, or appropriate laboratory investigation.
The ISTH SSC Bleeding Assessment Tool was developed by the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis to provide a standardized method for assessing bleeding symptoms in patients with suspected inherited bleeding disorders.
The score is calculated by adding the selected points from each bleeding domain. The severity of bleeding is determined not only by the presence of symptoms, but also by the clinical intervention or treatment required.
Important scoring principle
Symptoms and treatment occurring before or at the time of diagnosis should be considered. The distinction between score 0 and score 1 is important. A score of 1 indicates that the symptom is considered present by the interviewer but does not fulfill the criteria for a higher score.
Meaning of consultation only
Consultation only means that the patient sought medical evaluation and was referred to a specialist or was offered detailed laboratory investigation because of the bleeding symptom.
Tooth extraction and surgery
For procedures such as tooth extraction and surgery, the proportion of procedures associated with abnormal bleeding is relevant. For example, 1 of 1 procedure corresponds to 100 percent and qualifies for score 2. One of 2 corresponds to 50 percent and qualifies for score 2. One of 3 corresponds to approximately 33 percent and qualifies for score 2. One of 4 corresponds to 25 percent and qualifies for score 1.
PBAC consideration
A Pictorial Blood Assessment Chart score greater than 100 may support a score of 1 for menorrhagia when the PBAC result was already available at the time of assessment.
Clinical interpretation
In adult males, a total score from 0 to 3 is within the typical range, while a score of 4 or higher is considered atypical.
In adult females, a total score from 0 to 5 is within the typical range, while a score of 6 or higher is considered atypical.
In children younger than 18 years, a total score from 0 to 2 is within the typical range, while a score of 3 or higher is considered atypical.
Clinical use
The ISTH BAT is a structured bleeding history tool and should not be used as a standalone diagnostic test. An atypical score may support further evaluation for an inherited bleeding disorder, but interpretation should consider the clinical context, age, sex, medication exposure, comorbid conditions, and laboratory findings.
Important limitation
This calculator reproduces the published scoring framework for educational and clinical decision support purposes. It does not replace clinical judgment, hematology consultation, or appropriate laboratory investigation.
Important: The ISTH BAT is primarily intended to standardize bleeding history assessment. A high score does not establish a specific diagnosis by itself, and a low score does not completely exclude an inherited bleeding disorder.
References
- Rodeghiero F, Tosetto A, Abshire T, et al. ISTH SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. Journal of Thrombosis and Haemostasis. 2010;8(9):2063 to 2065. doi:10.1111/j.1538-7836.2010.03975.x
- Elbatarny M, Mollah S, Grabell J, et al. Normal range of bleeding scores for the ISTH BAT: adult and pediatric data from the merging project. Haemophilia. 2014;20(6):831 to 835. doi:10.1111/hae.12503
- Borhany M, Fatima N, Abid M, Shamsi T, Othman M. Application of the ISTH bleeding score in hemophilia. Transfusion and Apheresis Science. 2018;57(4):556 to 560.
- Gresele P, Orsini S, Noris P, et al. Validation of the ISTH SSC bleeding assessment tool for inherited platelet disorders: a communication from the Platelet Physiology SSC. Journal of Thrombosis and Haemostasis. 2020;18(3):732 to 739. doi:10.1111/jth.14683
- Srivastava A, Santagostino E, Dougall A, et al. WFH guidelines for the management of hemophilia, 3rd edition. Haemophilia. 2020;26(S6):1 to 158.
- Rezende SM, Neumann I, Angchaisuksiri P, et al. International Society on Thrombosis and Haemostasis clinical practice guideline for treatment of congenital hemophilia A and B based on GRADE methodology. Journal of Thrombosis and Haemostasis. 2024;22(9):2629 to 2652.
- Kalot MA, Husainat N, Tayiem S, et al. Bleeding assessment tools in the diagnosis of VWD in adults and children: a systematic review and meta analysis of test accuracy. Blood Advances. 2021;5(23):5023 to 5031.
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Appcardio may contain errors. Always verify the calculation and its accuracy before clinical use.