HEMSTOP

NOTE: Whilst we have done our utmost to ensure the accuracy of the data in this section, users should access the original publications. This will also allow you to see how the algorithm was created, the population studied and any limitations to the study.

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1. A modified HEMSTOP score has been developed - see References - to establish the role of the score in children. The modified score includes Gingival bleeding due to its significant association with Hereditary Bleeding Disorders [HBD].

If there was a history of gingival bleeding in the patient’s clinical history, a score of +1 was assigned. The addition of gingival bleeding to the HEMSTOP increased the sensitivity of the HEMSTOP score by approximately 10% in diagnosing primary haemostasis diseases in the population studied.
The HEMSTOP score may lose sensitivity in younger children due to a lack of a bleeding history in these patients. Therefore, it may be difficult to rely solely on the HEMSTOP score for young patients undergoing high-risk bleeding surgery. The relevant haemostatic tests should be considered prior to surgery in these cases.

1. Bonhomme F, Boehlen F, Clergue F, et al. Preoperative hemostatic assessment: a new and simple bleeding questionnaire. Can J Anaesth. 2016;63(9):1007-15.

2. Edme E, Sola C, Cau-Diaz I, et al. Gingival bleeding is a useful clinical feature in the diagnosis of hereditary bleeding disorders in children. Eur J Pediatr. 2024;183(5):2215-21.

Do you experience bruises/hematomas larger than 2 cm without trauma or severe bruising after minor trauma?
	Yes
	No
Do you experience bruises/hematomas larger than 2 cm without trauma or severe bruising after minor trauma?
	Yes	1 Point
	No	0 Points
After a tooth extraction, have you ever experienced prolonged bleeding requiring medical/dental consultation?
	Yes	1 Point
	No	0 Points
Have you experienced excessive bleeding during or after surgery?
	Yes	1 Point
	No	0 Points
Is there anyone in your family who suffers from a coagulation disease (such as hemophilia, von Willebrand disease, etc.)?
	Yes	1 Point
	No	0 Points
For Females
Have you ever consulted a doctor or received a treatment for heavy or prolonged menstrual periods (contraceptive pill, iron, etc.)?
	Yes	1 Point
	No	0 Points
Did you experience prolonged or excessive bleeding after delivery?
	Yes	1 Point
	No	0 Points

Interpretation
<2 points	Low Risk of Bleeding
≥2 points	Increased Risk of Bleeding

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