Practical-Manual-Scores-Algorithms-Haemostasis-Thrombosis

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BleedingISTH bleeding assessment tool for the evaluationof bleeding severityIndicationQuantitative assessment of the severity of bleeding symptoms in patients referredfor the evaluation of a suspected congenital bleeding disorder. Correlation ofclinical symptoms with biological parameters for research purposes.The Bleeding Assessment Tool (BAT) is formed by two components:1. Bleeding questionnaire: a detailed bleeding questionnaire has beenendorsed by the International Society of <strong>Haemostasis</strong> and <strong>Thrombosis</strong> as theresult of experts’ consensus. The bleeding questionnaire allows to accuratelyrecord the worst-ever presentation for each bleeding symptom. The bleedingquestionnaire is available at:http://www.isth.org/resource/resmgr/ssc/isth-ssc_bleeding_assessment.pdfA Web-based version of the questionnaire (ISTH-BATR) has been developedtogether by ISTH and the Rockefeller University, and it is accessible at:https://bh.rockefeller.edu/bat/Users willing to keep their patients’ information stored in the ISTH-BATR arestrongly encouraged to join the ISTH-BATR initiative, which is provided as afreely available service for the scientific community.Please visit http://www.isth.org/members/group.aspx?id=100549 orhttps://bh.rockefeller.edu/ISTH-BATR/ for full information on how to join theinitiative.2. Bleeding score: The severity of symptoms collected with the bleedingquestionnaire is scored and all obtained values are summed together. The finalresult is the Bleeding Score, an index of the overall severity of the bleedingphenotype.46
Symptoms(up to the time of diagnosis)Bleeding Assessment ToolScoreEpistaxis No / trivial • > 5/year or• more than10 minutesCutaneous No / trivial For bruises 5or more (> 1 cm)in exposed areasBleeding from minorwounds0 1 2 3 4No / trivial • > 5/year or• more than10 minutesConsultation only Packing or cauterizationor antifibrinolyticBlood transfusion or replacement therapy(use of hemostatic blood componentsand rFVIIa) or desmopressinConsultation only Extensive Spontaneous hematoma requiring bloodtransfusionConsultation only Surgical haemostasis Blood transfusion, replacement therapy,or desmopressinOral cavity No / trivial Present Consultation only Surgical haemostasisor antifibrinolyticGastrointestinalbleedingNo / trivial Present(not associatedwith ulcer, portalhypertension,hemorrhoids,angiodysplasia)Hematuria No / trivial Present(macroscopic)Tooth extraction No / trivialor nonedoneSurgery No / trivialor nonedoneReported in ≤ 25%of all procedures,no interventionReported in ≤ 25%of all procedures,no interventionConsultation only Surgical haemostasis,antifibrinolyticConsultation only Surgical haemostasis,iron therapyReported in > 25%of all procedures,no interventionReported in > 25%of all procedures,no interventionBlood transfusion, replacement therapyor desmopressinBlood transfusion, replacement therapyor desmopressinBlood transfusion, replacement therapyor desmopressinResuturing or packing Blood transfusion, replacement therapyor desmopressinSurgical haemostasisor antifibrinolyticBlood transfusion, replacement therapyor desmopressinBleeding47
Page 1 and 2: Practical manualScores and Algorith
Page 3: Scientific boardHenri BounameauxDiv
Page 6 and 7: SummaryBleedingISTH bleeding assess
Page 9 and 10: Clinical probability model for deep
Page 11 and 12: FeatureGeneva scoresPoints(revised
Page 13 and 14: InterpretationClinical decision rul
Page 15 and 16: 6 features with a similar validity.
Page 17 and 18: Prediction of recurrent deep vein T
Page 19 and 20: Outpatient versus inpatient care in
Page 21 and 22: Assessment of post-thrombotic syndr
Page 23 and 24: Diagnostic algorithm in suspected p
Page 25 and 26: Prediction of stroke risk in patien
Page 27 and 28: References• Camm AJ, Lip GY, De C
Page 29 and 30: References• Friberg L, Rosenqvist
Page 31 and 32: InterpretationThis score identifies
Page 33 and 34: Vienna score (Ay Model): DVT or PE
Page 35 and 36: Risk assessment modelsin hospitaliz
Page 37 and 38: References• Chopard P, Spirk D, B
Page 39 and 40: Recommendations for the determinati
Page 41 and 42: Template for scoring system for non
Page 43 and 44: Diagnosis of Thrombotic Thrombocyto
Page 45: Management of patientswith occlusio
Page 49 and 50: InterpretationA bleeding score > 3
Page 51 and 52: Pediatric Bleeding scoreSymptoms Sc
Page 53 and 54: Bleeding assessment tool for the ev
Page 55 and 56: The SMOG system (cont.)Type of blee
Page 57 and 58: The SMOG system (cont.)Type of blee
Page 59 and 60: Diagnostic and therapeutic algorith
Page 61 and 62: Bridging strategies in patients on
Page 64: Practical manualof scores and algor

Practical-Manual-Scores-Algorithms-Haemostasis-Thrombosis

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