BleedScore for Classifying Bleeding Events

Severity categories:

(1) superficial

(2) internal

(3) alarming

 

Superficial bleeding:

(1) easy bruising

(2) bleeding from small cuts

(3) petechiae

(4) ecchymosis

 

Internal bleeding:

(1) hematoma

(2) epistaxis

(3) blood loss from mouth

(4) blood loss from vagina

(5) melena

(6) eye bleeding

(7) hematuria

(8) hematemesis

 

Alarming bleeding:

(1) transfusion needed

(2) intracranial hemorrhage

(3) life-threatening bleeding

 

Parameter	Finding	Points
easy bruisability	absent	0
	present	1
bleeding from small cuts	absent	0
	present	1
petechiae	absent	0
	present	1
ecchymosis	absent	0
	present	1
hematoma	absent	0
	present	3
epistaxis	absent	0
	present	3
blood loss from mouth	absent	0
	present	3
blood loss from vagina	absent	0
	present	3
melena	absent	0
	present	3
eye bleeding	absent	0
	present	3
hematuria	absent	0
	present	3
hematemesis	absent	0
	present	3
transfusion necessary	absent	0
	present	6
intracranial bleeding	absent	0
	present	6
life threatening hemorrhage	absent	0
	present	6

 

where:

• A life threatening hemorrhage that requires transfusion might be scored as 12 or 6.

 

subscore for superficial bleeding =

= SUM(points for all 4 parameters)

 

subscore for internal bleeding =

= SUM(points for all 8 parameters)

 

subscore for alarming bleeding =

= SUM(points for all 3 parameters)

 

total score =

= SUM(points for all 15 items)

 

Interpretation:

• minimum total score: 0

• maximum total score: 46 for a female, 43 for a male

• The higher the score the more severe the bleeding.

 

Limitations:

• Some conditions such as epistaxis may range from mild to severe.

• Whether the bleeding can be controlled is often clinically important.