Mahoney and Shapshay graded the severity of epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). This can help to compare the response to various therapies. The authors are from Boston University Medical Center.
Parameters:
(1) frequency of bleeding
(2) lifetime need for blood transfusions
Frequency
Lifetime Blood Transfusion
Severity
1 to 2 episodes per week
none
mild
1 to 2 episodes per day
< 10
moderate
daily and lasting > 30 minutes
>= 10
severe
where:
• The classification could be modified to include very mild, mild-to-moderate and moderate-to-severe categories.
Comparisn with other schemes for grading epistaxis severity:
• Other schemes for classifying epistaxis use any blood transfusion as being indicative of severe disease.
• A frequency of 1 to 2 episodes per week is relatively frequent for many patients with other causes of epistaxis.
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