Ann Coloproctol.
2021 Oct;37(5):311-317. 10.3393/ac.2020.08.19.
Proposal for a New Score: Hemorrhoidal Bleeding Score
- Affiliations
-
- 1Service de Proctologie Médico-Chirurgicale, GH Paris Saint-Joseph, Paris, France
- 2Centre de Recherche Clinique, GH Paris Saint-Joseph, Paris, France
- 3Centre d’Investigation Clinique 1418 (CIC1418), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
- 4Faculté de Médecine, Université de Paris, Paris, France
- 5Service de Radiologie Vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
- KMID: 2521901
- DOI: http://doi.org/10.3393/ac.2020.08.19
Abstract
- Purpose
We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
Methods
All consecutive patients who had consulted between May 1, 2016 and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in 2 stages. The first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
Results
One hundred consecutive patients were studied (57 males; mean age, 49.70 years). A positive association between HBS and surgery indication was found (P<0.001). A cut-off value of the score of 5 (≤5 vs. >5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25%, respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (odds ratio, 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (P<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 males; mean age, 53.14 years) were enrolled with an excellent agreement between 2 proctologists (kappa=0.983).
Conclusion
HBS is sensitive, specific, and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients and does so in a more efficient way than the Goligher prolapse score. It also allows quantifying the extent of change in hemorrhoidal bleeding after treatment.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Submucosal Hemorrhoidal Artery Ligation Technique and Shortening Suture Technique for a Hemorrhoidectomy
- Early Experience with Doppler-guided Hemorrhoidal Artery Ligation
- Modified Anal Cushion Preserving Hemorrhoidectomy
- Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome
- Clinical Usefulness of Rockall Scoring System in Patients with Bleeding Peptic Ulcer-Comparison with Forrest Classification
