Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Otorhinolaryngology, Università degli Studi di Pavia, Pavia, Italy.
Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Rhinology. 2020 Oct 1;58(5):516-521. doi: 10.4193/Rhin20.078.
Hereditary haemorrhagic telangiectasia (HHT) is a rare disease characterized by a multisystemic vascular dysplasia and epistaxis, that is the most common cause of disability and social impairment. Patient management strictly depends on the severity of this symptom; therefore, it is of paramount importance for the clinicians to effectively grade epistaxis severity. The aim of this report was to validate the Frequency, Intensity and Duration score (FID) for grading epistaxis severity in patients with HHT; we studied repeatability and external validity comparing FID score with Epistaxis Severity Score (ESS).
This is a descriptive, observational study that included 264 adult HHT patients with epistaxis. Diagnosis of HHT was established with Curacao criteria or positivity at genetic testing. Nosebleed severity was evaluated according to the FID score and the ESS. The first 30 patients were included in the validation of the FID score, which was graded on days 0, 1, 3 and 7. In the remaining 234 patients, a comparison between the ESS and FID score was performed.
The statistical analysis performed in order to validate the FID score showed very good agreement between scores calculated on different days; analysis comparing the FID score with the ESS revealed a high correlation between the two grading systems.
The FID score is a quick, easy and precise tool for evaluating HHT-related epistaxis and could be a possible alternative to the ESS. The FID score meets the need for an intuitive and smart grading system that is easy to manage in clinicians’ hands.
遗传性出血性毛细血管扩张症（HHT）是一种罕见的疾病，其特征为多系统血管发育不良和鼻出血，这是导致残疾和社会功能障碍的最常见原因。患者管理严格取决于该症状的严重程度；因此，临床医生有效分级鼻出血的严重程度至关重要。本报告的目的是验证用于分级 HHT 患者鼻出血严重程度的频率、强度和持续时间评分（FID）；我们通过将 FID 评分与鼻出血严重程度评分（ESS）进行比较，研究了重复性和外部有效性。
这是一项描述性、观察性研究，纳入了 264 例有鼻出血的成年 HHT 患者。HHT 的诊断依据是 Curacao 标准或基因检测阳性。根据 FID 评分和 ESS 评估鼻出血严重程度。前 30 例患者纳入 FID 评分验证，评分在第 0、1、3 和 7 天进行。在其余 234 例患者中，比较了 ESS 和 FID 评分。
为验证 FID 评分而进行的统计分析显示，不同日期计算的评分之间具有非常好的一致性；FID 评分与 ESS 比较分析显示两种分级系统之间具有高度相关性。
FID 评分是一种用于评估 HHT 相关鼻出血的快速、简单且准确的工具，可能是 ESS 的替代方法。FID 评分满足了一种直观且智能的分级系统的需求，便于临床医生管理。
