Hoag et al developed an Epistaxis Severity Score (ESS) for patients with hereditary hemorrhagic telangiectasia (HHT). The authors are from Drexel University and the Johns Hopkins University.
(1) typical frequency of nosebleeds
(2) typical duration of a nosebleed
(3) typical intensity of a nosebleed
(4) medical attention for a nosebleed
(5) current anemia
(6) blood transfusion for a nosebleed
frequency of nosebleeds
less than monthly
once per month
once per week
several per week but not daily
once per day (daily)
several times a day
duration of a nosebleed
< 1 minute
1 to 5 minutes
6 to 15 minutes
16 to 30 minutes
> 30 minutes
intensity of nosebleeds
not gushing or pouring
gushing or pouring
sought medical attention
blood transfusion for nosebleed
total score =
= (0.14 * (points for frequency)) + (0.25 * (points for duration)) + (0.25 * (points for intensity)) + (0.30 * (points for medical attention)) + (0.20 * (points for anemia)) + (0.31 * (points for blood transfusion))
normalized ESS =
= (total score) / 2.76 * 10 =
= (total score) * 3.6231
• The paper gives 2.71 as the denominator but if you add up the values it should be 2.76.
• minimum total score: 0
• maximum total score: 2.76 (origin for the denominator for normalized ESS)
• minimum normalized ESS: 0
• maximum normalized ESS: 10
• The higher the normalized ESS the worse the epistaxis.
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Purpose: To evaluate the severity of nosebleeds in a patient with hereditary hemorrhagic telangiectasia (HHT) using the Epistaxis Severity Scale of Hoag et al.
Specialty: Otolaryngology, Hematology Oncology
Objective: severity, prognosis, stage