Proposal for a New Score: Hemorrhoidal Bleeding Score

Nadia Fathallah; Hélène Beaussier; Gilles Chatellier; Jean Meyer; Marc Sapoval; Nadia Moussa; Vincent de Parades

doi:10.3393/ac.2020.08.19

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저자정보: Nadia Fathallah (GH Paris Saint-Joseph) Hélène Beaussier (GH Paris Saint-Joseph) Gilles Chatellier (Hôpital Européen Georges-Pompidou) Jean Meyer (GH Paris Saint-Joseph) Marc Sapoval (Hôpital Européen Georges-Pompidou) Nadia Moussa (Hôpital Européen Georges-Pompidou) Vincent de Parades (GH Paris Saint-Joseph)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.37 No.5

발행연도: 2021.10

수록면: 311 - 317 (7page)

DOI: 10.3393/ac.2020.08.19

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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.

#Hemorrhoidal treatment #Surgery #Hemorrhoids #Gastrointestinal bleeding #Prolapse

참고문헌 (22)

참고문헌 신청

Sandler RS / 2019 / Rethinking what we know about hemorrhoids / Clin Gastroenterol Hepatol 17:8~15

Goligher JC / 1980 / Surgery of the anus, rectum and colon / Bailliere Tindall :96

Moussa N / 2017 / Embolization of the superior rectal arteries for chronic bleeding due to haemorrhoidal disease / Colorectal Dis 19:194~199

Tradi F / 2018 / Embolization of the superior rectal arteries for hemorrhoidal disease: prospective results in 25 patients / J Vasc Interv Radiol 29:884~892

Higuero T / 2016 / Guidelines for the treatment of hemorrhoids (short report) / J Visc Surg 153:213~218

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