haematology

ISTH Bleeding Assessment Tool (ISTH-BAT)

ISTH/SSC Bleeding Assessment Tool: a standardised bleeding history for suspected inherited bleeding disorders (von Willebrand disease, platelet function disorders, factor deficiencies). Abnormal bleeding score: ≥ 4 in adult men, ≥ 6 in adult women, ≥ 3 in children.

Epistaxis*

Cutaneous bleeding (bruising)*

Bleeding from minor wounds*

Oral cavity bleeding*

Gastrointestinal bleeding*

Haematuria*

Tooth extraction*

Surgery*

Menorrhagia (0 if male or not applicable)*

Post-partum haemorrhage (0 if no deliveries)*

Muscle haematomas*

Haemarthrosis*

Central nervous system bleeding*

Other bleeding (e.g. umbilical stump, cephalohaematoma, circumcision, venepuncture)*

Score interpretation

Bleeding Score 0–2 — Normal 0–2

Within the normal range for children (0–2), adult men (0–3) and adult women (0–5).

→ No further haematological work-up for bleeding symptoms alone; investigate if a family history or laboratory finding raises suspicion.

Bleeding Score 3 — Abnormal in Children 3

Abnormal for children (≥ 3); within the normal range for adult men and women.

→ Child: refer to haematology (von Willebrand disease, platelet function disorder, factor deficiency). Adult: interpret with the clinical picture.

Bleeding Score 4–5 — Abnormal in Men and Children 4–5

Abnormal for adult men (≥ 4) and children; within the normal range for adult women (0–5).

→ Men and children: refer to haematology for bleeding-disorder investigation. Women: interpret with the clinical picture.

Bleeding Score ≥ 6 — Abnormal 6–56

Above the normal range for adult men, adult women and children.

→ Refer to haematology; investigate for von Willebrand disease, platelet function disorder or coagulation factor deficiency.

Interpretation bands for the ISTH-BAT. Apply clinical judgement and local guidance.

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. J Thromb Haemost. 2010;8(9):2063-2065.
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):831-835.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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