Tosetto et al developed a clinical bleeding score to describe the severity of bleeding for a patient with von Willebrand disease. The authors are from S. Bortolo Hospital in Vicenza, Italy.
(2) cutaneous bleeding
(3) bleeding from minor wounds
(4) bleeding from the oral cavity
(5) bleeding associated with tooth extraction
(6) gastrointestinal tract bleeding
(7) surgical bleeding
(8) muscle hematomas
(10) central nervous system (CNS) bleeding
(11) for a woman, menorrhagia
(12) for a woman, post-partum bleeding
none or trivial
present but controlled
requires packing or cautery
requires blood transfusion or vWF replacement
required consultation, blood transfusion, surgery
bleeding from minor wounds
several for > 5 minutes
surgical hemostasis, blood transfusion, vWD replacement
bleeding from the oral cavity
bleeding with dental extractions
suturing or packing required
blood transfusion required
gastrointestinal tract bleeding
associated with ulcer or other GI pathology
spontaneous or consultation required
suturing or resurgery
consult required, iron, pill use
blood transfusion, dilation and curettage, hysterectomy
present but controlled, may need iron
blood transfusion, dilation and curettage, suturing
• There are 2 sets of responses for several items (epistaxis, bleeding from minor wounds, gastrointestinal bleeding, tooth extraction bleeding, surgical bleeding, menorrhagia, post-partum bleeding, muscle hematoma and hemarthrosis).
• The authors developed 2 different scores, one with points assigned from 0 to 3 and the second from -1 to 4. The version above is for the 0 to 3 score. The -1 to 4 score has more choices.
bleeding score =
= SUM(points for all of the applicable parameters)
• minimum score: 0
• maximum score: 36
• The higher the score the greater the bleeding severity.
• Normal male will have a bleeding score < 3 and a normal female will have a score < 5.
• A bleeding score > 3 in males and > 5 in females indicates a bleeding tendency that needs to be evaluated and which may represent von Willebrand's disease.
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Specialty: Hematology Oncology, Clinical Laboratory