An Epistaxis Severity Score for Hereditary Hemorrhagic Telangiectasia
An Epistaxis Severity Score for Hereditary Hemorrhagic Telangiectasia
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DOI：
10.1002/lary.20818
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发表时间：
2010-04-01
期刊：
影响因子：
2.6
通讯作者：
Merlo, Christian A.
中科院分区：
文献类型：
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作者：
Hoag, Jeffrey B.;Terry, Peter;Merlo, Christian A.
目的/假设：遗传性出血性毛细血管扩张症（HHT）相关的鼻出血导致社会功能和生活质量的改变。虽然超过95%的鼻出血的经验，有相当大的变化的严重程度。由于没有标准化的方法存在，以衡量鼻出血的严重程度，本研究的目的是确定与患者报告的严重程度，以制定一个严重scores.Study设计：前瞻性，调查为基础的studyMethods：HHT护理提供者和一个焦点小组的患者进行了采访，以确定鼻出血相关的因素，从这个，电子调查的发展和管理与HHT患者。进行描述性分析，计算连续变量的平均值和中位数以及分类变量的比例。多元有序逻辑和线性回归模型，以确定鼻出血severity.Results的危险因素：九百名受访者来自21个国家。855例（95%）受试者报告了鼻衄。平均（标准差）年龄为52.1（13.9）岁，61.4%为女性。自我报告的鼻出血严重程度的独立相关危险因素包括鼻出血频率（比值比[OR] 1.57），持续时间（OR 2.17），强度（OR 2.45），需要输血（OR 2.74），贫血（OR 1.44），需要积极治疗（OR 1.53，P < .001）。结论：HHT患者鼻出血严重程度增加的危险因素包括发作频率、持续时间和强度;停止鼻出血所需的既往治疗的侵入性;贫血;以及输血的需要。根据这些因素，将列出鼻出血严重程度评分。
Objectives/Hypothesis: Hereditary hemorrhagic telangiectasia (HHT)-related epistaxis leads to alterations in social functioning and quality of life. Although more than 95% experience epistaxis, there is considerable variability of severity. Because no standardized method exists to measure epistaxis severity, the purpose of this study was to determine factors associated with patient-reported severity to develop a severity score.Study Design: Prospective, survey-based studyMethods: HHT care providers and a focus group of patients were interviewed to determine epistaxis-associated factors From this, an electronic survey was developed and administered to patients with HHT. Descriptive analyses were performed with calculations of means and medians for continuous and proportions for categorical variables. Multiple ordinal logistic and linear regression models were developed to determine risk factors for epistaxis severity.Results: Nine hundred respondents from 21 countries were included. Eight hundred fifty-five (95%) subjects reported epistaxis. The mean (standard deviation) age was 52.1 (13.9) years, and 61.4% were female. Independently associated risk factors for self-reported epistaxis severity included epistaxis frequency (odds ratio [OR] 1.57), duration (OR 2.17), intensity (OR 2.45), need for transfusion (OR 2.74), anemia (OR 1.44), and aggressiveness of treatment required (OR 1 53, P < .001 for all).Conclusions: Risk factors for increasing epistaxis severity in patients with HHT include frequency, duration, and intensity of episodes; invasiveness of prior therapy required to stop epistaxis; anemia; and the need for blood transfusion. From these factors, an epistaxis severity score will be presented.