Abstract Number: PB1069
Meeting: ISTH 2022 Congress
Background: The ISTH-Bleeding Assessment Tool(BAT) was devised to aid in identification of patients with bleeding diathesis by improving reproducibility of bleeding history. The utility of ISTH-BAT in assessing bleeding severity is still elusive.
Aims: To assess the utility of ISTH-BAT to identify probable bleeders with primary or secondary haemostasis defects and to differentiate between severe and non-severe bleeders.
Methods: Participants referred for bleeding workup were recruited and grouped into “bleeders” and “non-bleeders” based on established cut-offs for abnormal BAT Score (males:>3, females:>5, children:>2). Patients were also grouped according to clinical bleeding severity into “severe bleeders” and “non-severe bleeders”. Severe bleeders were defined as those with life-threatening hemorrhages, multiple muscle hematomas, umbilical cord, gastrointestinal, CNS bleeding, >2 joints involvement by hemathroses or factor concentrate/transfusion requirement >5 times/year. Non-severe bleeders were defined as those who bled only after trauma/surgery, bled less frequently, < 2 joints involvement, less transfusion requirement, only minor symptoms like mucocutaneous bleeds. Detailed coagulation workup was performed including one-stage clot-based factor assays, light transmission aggregometry, ristocetin-cofactor assay and von willebrand antigen. Participants with normal results were taken as controls.
Results: A total of 76 controls and 395 patients (primary haemostasis defects n=244, secondary haemostasis defects n=151) were recruited. Patients had ISTH-BAT score ranging from 0 to 28 (Median:7,IQR:5-11). Age of patients ranged from 6days to 69years (Median:11years). ISTH-BAT score had overall 98.21% sensitivity, 95% negative predictive value(NPV) to identify bleeders with primary haemostasis defects, and 93.3% sensitivity, 91.9% NPV to identify bleeders with secondary haemostasis defects. The sensitivity and NPV further increased to 100% for severe bleeders with Glanzmann Thrombasthenia, Bernard Soulier Syndrome, VWD and Severe Hemophilia A/B(Figure1). There was significant overlap up to a score of 15 between clinically severe and non-severe bleeders(Figure2).
Conclusion(s): ISTH-BAT is very useful screening tool to identify bleeders with primary/secondary haemostasis defects but may not predict bleeding severity.
To cite this abstract in AMA style:Dave R, Geevar T, Mammen J, Vijayan R, Gowri M, Nair S. Utility of ISTH Bleeding Assessment Tool in identifying bleeders and predicting bleeding severity in inherited primary and secondary haemostasis defects [abstract]. https://abstracts.isth.org/abstract/utility-of-isth-bleeding-assessment-tool-in-identifying-bleeders-and-predicting-bleeding-severity-in-inherited-primary-and-secondary-haemostasis-defects/. Accessed September 22, 2023.
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