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.
Parameters:
(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
|
Parameter |
Finding |
Points |
|
frequency of nosebleeds |
less than monthly |
0 |
|
|
once per month |
1 |
|
|
once per week |
2 |
|
|
several per week but not daily |
3 |
|
|
once per day (daily) |
4 |
|
|
several times a day |
5 |
|
duration of a nosebleed |
< 1 minute |
0 |
|
|
1 to 5 minutes |
1 |
|
|
6 to 15 minutes |
2 |
|
|
16 to 30 minutes |
3 |
|
|
> 30 minutes |
4 |
|
intensity of nosebleeds |
not gushing or pouring |
0 |
|
|
gushing or pouring |
1 |
|
sought medical attention |
never |
0 |
|
|
ever |
1 |
|
current anemia |
no |
0 |
|
|
yes |
1 |
|
blood transfusion for nosebleed |
no |
0 |
|
|
yes |
1 |
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
where:
• The paper gives 2.71 as the denominator but if you add up the values it should be 2.76.
Interpretation:
• 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.
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
ICD-10: I78.0,
