Stępień Katarzyna, Reich Adam
Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland.
Front Med (Lausanne). 2020 Dec 17;7:614005. doi: 10.3389/fmed.2020.614005. eCollection 2020.
Assessment of pruritus still remains a challenge due to its subjective character. Various itch questionnaires are widely used to evaluate the severity of pruritus. The aim of the current study was to define the cut off values for the 12-Item Pruritus Severity Scale (12-PSS). A total of 240 patients (86 males and 154 females) in the age between 19 and 87 years (mean 52.9 ± 20.7 years) suffering from pruritic dermatological conditions were asked to assess their maximal pruritus with the 12-PSS, the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS). All subjects also completed the Dermatology Life Quality Index (DLQI). VRS, NRS, and DLQI scorings were used as anchor measures to define cut-offs of 12-PSS. According to VRS, 43 (17.9%) patients suffered from mild, 96 (40%) from moderate, 65 (27.1%) from severe and 36 (15%) from very severe pruritus. Mean 12-PSS scoring for each VRS category was 7.6 ± 3.9, 10.4 ± 3.9, 13.0 ± 3.8, and 13.9 ± 3.8 points, respectively ( < 0.001). Each VRS category significantly differed from the others regarding the mean 12-PSS scoring, except the mean scoring of severe and very severe pruritus ( = 0.72). Thus, three pruritus severity categories of 12-PSS were defined with following score ranges: mild pruritus-3-6 points of 12-PSS, moderate pruritus-7-11 points of 12-PSS and severe pruritus-12-22 points of 12-PSS based on calculation of weighted κ coefficient against VRS, NRS, and DLQI as anchor measures. The 12-PSS is able to differentiate between patients suffering from mild, moderate, and severe pruritus.
由于瘙痒的主观性，对其进行评估仍然是一项挑战。各种瘙痒问卷被广泛用于评估瘙痒的严重程度。本研究的目的是确定12项瘙痒严重程度量表（12-PSS）的临界值。共有240例年龄在19至87岁（平均52.9±20.7岁）之间患有瘙痒性皮肤病的患者（86例男性和154例女性）被要求使用12-PSS、视觉模拟评分法（VRS）和数字评分法（NRS）评估其最大瘙痒程度。所有受试者还完成了皮肤病生活质量指数（DLQI）。VRS、NRS和DLQI评分被用作确定12-PSS临界值的锚定指标。根据VRS，43例（17.9%）患者患有轻度瘙痒，96例（40%）患有中度瘙痒，65例（27.1%）患有重度瘙痒，36例（15%）患有极重度瘙痒。每个VRS类别对应的平均12-PSS评分分别为7.6±3.9、10.4±3.9、13.0±3.8和13.9±3.8分（<0.001）。除重度和极重度瘙痒的平均评分外（=0.72），每个VRS类别在平均12-PSS评分方面与其他类别均有显著差异。因此，基于以VRS、NRS和DLQI作为锚定指标计算加权κ系数，将12-PSS的瘙痒严重程度分为三个类别，其评分范围如下：轻度瘙痒-12-PSS评分为3-6分，中度瘙痒-12-PSS评分为7-11分，重度瘙痒-12-PSS评分为12-22分。12-PSS能够区分轻度、中度和重度瘙痒患者。
