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Sistema de puntaje para epistaxis

ADDITIONAL INFORMATION

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Epistaxis Scoring System (ESS)

Authors/developers

Katsanis E, Luke K-H, Hsu E, Li M, Lillicrap D

Scoring system

N.B.: These scores are posted with the permission of the developers.

[/vc_column_text][mpc_tabs preset=”mpc_preset_11″ tabs_position=”left” active_tab=”0″ decor_line=”true” decor_color=”#616265″ decor_active=”#616265″ decor_size=”2″ decor_gap=”10″ font_preset=”preset_0″ font_color=”#888888″ font_size=”14″ font_line_height=”1.75″ font_align=”left” content_padding_divider=”true” content_padding_css=”padding-top:20px;padding-right:0px;padding-bottom:10px;padding-left:0px;” background_color=”#f7f7f7″ padding_css=”padding:30px;” margin_divider=”true” margin_css=”margin-right:10px;margin-left:20px;” mpc_button__font_preset=”preset_1″ mpc_button__font_color=”#e31837″ mpc_button__font_size=”16″ mpc_button__font_transform=”none” mpc_button__font_align=”left” mpc_button__border_divider=”true” mpc_button__border_css=”border-radius:15px;” mpc_button__padding_divider=”true” mpc_button__padding_css=”padding-right:20px;padding-left:20px;” mpc_button__hover_font_color=”#ffffff” mpc_button__hover_background_color=”#008bb0″ mpc_button__hover_background_effect=”expand-horizontal” mpc_button__hover_border_divider=”true” mpc_button__hover_border_css=”border-radius:0px;” button_margin_divider=”true” button_margin_css=”margin-right:0px;margin-left:0px;”][mpc_tab title=”Description” tab_id=”1468785295-1-20b60e-72e13c95-2e8a4cbe-d112″][vc_column_text css=”.vc_custom_1486397266571{margin-left: 0px !important;border-left-width: 0px !important;padding-left: 20px !important;}”]The ESS assesses severity of epistaxis and can be used to identify patients who require a bleeding diasthesis workup. The target population is children with epistaxis.

Contact person:
E Katsanis: [email protected]

Date of this review: August 26, 2013
Updated: April, 2014[/vc_column_text][/mpc_tab][mpc_tab title=”Utility” tab_id=”1468785295-2-99b60e-72e13c95-2e8a4cbe-d112″][vc_column_text css=”.vc_custom_1475158007367{padding-left: 20px !important;}” el_class=”arrow”]Overall utility:

Useful in the pediatric clinical setting of epistaxis only for assessing which children should have further investigations.

Limitations:

  • Expert administered
  • Although one study did show little validity in differentiating children with a coagulopathy vs. without, it is important to note that that study, unlike the initial study, was retrospective and no specific definition of recurrent epistaxis for patient inclusion was recorded.

[/vc_column_text][/mpc_tab][mpc_tab title=”Administration” tab_id=”1468785421664-2-2b60e-72e13c95-2e8a4cbe-d112″][vc_column_text css=”.vc_custom_1475158170930{padding-left: 20px !important;}” el_class=”arrow”]1.  Time to complete: Not documented, but very few questions therefore likely short

2.  Equipment/space required: None

3.  Training required: Expert-administered; no training specific to the administration of the scoring tool is required

4.  Cost: None

5.  Scoring/scaling/interpretation of results:

  • Scale 0–2 for each of 5 epistaxis bleeding symptoms
  • Possible range of total score 0–10
  • Abnormal bleeding score (BS) (or severe epistaxis) ≥7

[/vc_column_text][/mpc_tab][mpc_tab title=”Psychometrics” tab_id=”1468785430492-3-3b60e-72e13c95-2e8a4cbe-d112″][vc_column_text css=”.vc_custom_1475159030913{padding-left: 20px !important;}” el_class=”arrow”]Psychometric properties:

1.  Construct validity:

Convergent validity

  • Only children with an abnormal bleeding score (BS) had a history of needing cautery.1
  • Abnormal BS was associated with increased prevalence of anemia.1
  • Bleeding time was more likely to be prolonged in those with an abnormal BS.1

Group differences

  • Family history of a bleeding diathesis was more likely in those with severe epistaxis than mild.1
  • All children with a bleeding history (other than epistaxis) had an abnormal BS, whereas no child with mild epistaxis (normal BS) had other bleeding1
  • A second study showed no difference in BS in children with recurrent epistaxis and coagulopathy vs. no coagulopathy.2

2.  Criterion validity: The two patients with VWD in the initial study were identified as having an abnormal BS.1

3.  Reliability: No studies identified

4.  Responsiveness/sensitivity: No studies identified

Languages studied: English

Groups tested with this measure: Children with epistaxis1,2

Age: Children only

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  1. Katsanis E et al. Prevalence and significance of mild bleeding disorders in children with recurrent epistaxis. J Pediatr 1988; 113: 73-76.
  2. Sandoval C et al. Clinical and laboratory features of 178 children with recurrent epistaxis. J Pediatr Hematol Oncol 2002; 24: 47-49.

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