P45 An analysis of infantile haemangioma referrals and comparison with the infantile haemangioma European task force’s ‘infantile haemangioma referral score’

Abstract

Abstract Infantile haemangiomas (IHs) are common. Timely referral and treatment can minimize complications in high-risk lesions. The IH European Task Force developed the Infantile Haemangioma Referral Score (IHRes) in 2020 (Léauté-Labrèze C, Torres EB, Weibel L et al. The Infantile Hemangioma Referral Score: a validated tool for physicians. Pediatrics 2020; 145:e20191628). This is a simple, easy-to-access validated screening tool that can assist physicians in deciding which IHs to refer to an expert centre. The aim of this study was to assess the quality of IH referrals to a national care centre. Data were retrospectively collected from a random sample of patients over a 13-month period between January 2019 and February 2020. Fifty-six patients were included. Eighty-six per cent had a solitary haemangioma (n = 48); 52% of IHs were located on the head (n = 29). Sixteen patients (29%) were referred between 5 and 8 weeks of age (29%); five patients (9%) were referred before 5 weeks of age. The majority of referrals came from primary care (55%; n = 31). Seventy-three per cent of referrers did not specify the urgency of the referrals (n = 41); 59% were subsequently triaged as urgent by a consultant dermatologist (n = 33). Most referrals did not specify the size of the IH (43%; n = 24), if it was actively growing (48%; n = 27), ulcerated (93%; n = 52) or potentially function threatening (84%; n = 47). Nine per cent included a photograph of the lesion (n = 5). Seventy-five per cent of referrals satisfied the IHRes six major criteria or had scores > 4, warranting a referral (n = 42). Fifteen patients (27%) were started on propranolol at first appointment and a further 12 were monitored in a return appointment. Our results show that use of the IHReS tool could improve clinical outcomes by identifying children that require specialist referral earlier and facilitate easier triage of referrals.