Standardised bleeding-symptom score used to screen for inherited bleeding disorders such as von Willebrand disease.
ISTH-SSC Bleeding Assessment Tool
Patient group
Sets the threshold used to flag the total score as abnormal.
Epistaxis
Cutaneous bruising
Bleeding from minor wounds
Oral cavity bleeding (gums, tongue/lip biting)
Gastrointestinal bleeding
Hematuria (macroscopic)
Bleeding after tooth extraction
Bleeding after surgery
Menorrhagia (heavy menstrual bleeding)
Score 0 if not applicable.
Post-partum haemorrhage
Score 0 if not applicable.
Muscle haematoma
Haemarthrosis (joint bleeding)
Central nervous system bleeding
Other bleeding (e.g. cephalohematoma, umbilical stump, iatrogenic, unusual site)
Result0 points
Score is within the normal reference range reported for a adult male (abnormal is ≥ 4).
Total bleeding score
0 / 56
Abnormal threshold for this group
≥ 4 (adult male)
When to use
Structured quantification of mucocutaneous and other bleeding symptoms in a patient being evaluated for a possible inherited bleeding disorder (e.g. von Willebrand disease, platelet function disorder).
Not a diagnostic test by itself - an abnormal score should prompt directed laboratory testing.
Formula
Sum of severity grades (0-4 per domain, this implementation uses generic 0-4 anchors) across 14 bleeding symptom domains: epistaxis, cutaneous bruising, minor-wound bleeding, oral cavity, GI, hematuria, tooth extraction, surgery, menorrhagia, post-partum haemorrhage, muscle haematoma, haemarthrosis, CNS bleeding, and other. Range 0-56. Abnormal thresholds from population reference data: ≥ 4 (adult male), ≥ 6 (adult female), ≥ 3 (child).
Pearls and pitfalls
Replaced earlier, less standardised bleeding questionnaires and is the basis for later tools such as the self-administered ISTH-BAT (Self-BAT).
Reference ranges and abnormal cutoffs come from a separate, later normal-population study, not the original 2010 proposal.