Mild to moderate bleeding: diagnostic and therapeutic paths

Abstract

We consider mild to moderate bleedings all bleeding events that do not meet the criteria proposed by the International Society of Thrombosis and Haemostasis (ISTH) for the definition of major bleeding. As regards the approach to the bleeding patient, the first step is undoubtedly an accurate collection of clinical history and overall physical examination. Then, the etiological diagnosis of a bleeding disorder uses a series of laboratory investigations, divided into first level tests, which are intended to identify the altered phase of the hemostatic process, and second level ones, i.e. more specific tests used if screening tests are negative or to better characterize the alteration identified by them. For the treatment of a bleeding disorder there are several approaches, all strictly dependent on the etiologic diagnosis of this disorder.