Abstract
Background
: Bleeding assessment tools (BATs) have been developed to quantify bleeding severity.
Their ability to predict for the diagnosis of a bleeding disorder has not been thoroughly
investigated.
Objectives
: To evaluate the ability of the Vicenza BAT and the ISTH BAT to distinguish patients
with an established bleeding disorder from those with bleeding of unknown cause (BUC).
Patients/Methods
: Three-hundred fifty-nine patients (228 with BUC, 64%) from the Vienna Bleeding Biobank
were assessed in this study.
Results
: The bleeding scores were similar in patients with an established diagnosis of a
bleeding disorder compared to patients with BUC. Both BATs had a low sensitivity and
specificity for the diagnosis of a bleeding disorder with areas under the receiver
operating characteristic (ROC) curves of 0.53 (95% confidence interval 0.47–0.60)
for the Vicenza BAT and 0.52 (0.46–0.59) for the ISTH BAT. In terms of specific diagnoses,
both scores were most accurate in diagnosing von Willebrand disease (VWD, areas under
the ROC curve; Vicenza BAT 0.67 (0.45–0.90); ISTH BAT 0.70 (0.50–0.90)). A separate
evaluation of different bleeding symptoms in patients who had undergone surgery and
tooth extraction revealed that postpartum bleeding and bleeding from small wounds
was predictive for diagnosing a MBD in multivariable analysis.
Conclusions
: The Vicenza- and the ISTH BAT have a low ability to distinguish patients with an
established bleeding disorder from those with BUC.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: April 18, 2020
Accepted:
April 6,
2020
Received in revised form:
February 24,
2020
Received:
December 2,
2019
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
