Leaute-Labreze et al reported the Infantile Hemangioma Referral Score (IHReS) for evaluating an infant with an hemangioma. This can help to identify those patients who should be referred to an export. The authors are from multiple institutions in Europe.
Patient: infantile hemangioma
Outcome: referral to specialist at an expert center
Indications for referral to a specialist:
(1) complications (ulceration, visual compromise, feeding difficulties, stridor) or at risk for complications
(2) involvement of central face
(3) involvement of ears
(4) involvement of breast in girls
(5) midline involvement over the lumbosacral region
(6) diameter >= 4 cm
(7) number of hemangiomas >= 5
If none of the above are present, then the patient is evaluated for additional features:
(1) location of involvement
(2) size of the largest hemangioma
(3) age in months and recent growth
|
Parameter
|
Finding
|
Points
|
|
location
|
other facial areas not listed above
|
3
|
|
|
neck or scalp
|
2
|
|
|
diaper area
|
2
|
|
|
other
|
0
|
|
size
|
other facial areas not listed at above AND >=1 cm in diameter
|
3
|
|
|
2 to 4 cm
|
2
|
|
|
other
|
0
|
|
age and recent change
|
< 2 months old
|
3
|
|
|
2 to 4 months old AND growth evident in past 2 weeks
|
2
|
|
|
other
|
0
|
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A score >= 4 is an indication to be referred to a specialist.
Performance:
• The sensitivity is 0.97 and specificity 0.55.
