Supplementary Material for: Sodergren score translation and validation for hemorrhoidal disease in a Portuguese cohort

Aim: This study aimed to validate the Sodergren Score (SS) in the Portuguese population and develop a new model incorporating symptoms and quality-of-life variables.
Methods: A single-center, cross-sectional study, conducted in patients diagnosed with grade I-III hemorrhoidal disease (HD) by gastroenterologists specialized in proctology, between January and December 2023. The SS was translated and validated into Portuguese. Patients completed the Portuguese version of the SS and the EUROHIS-QOL-8. Demographic and clinical data were collected. The SS was validated using ROC curve analysis for identification of failure of office-based treatments (OBT), defined as the need for ≥ 4 OBT. Additionally, based on SS variables, a new model (Amadora-Sintra) was developed, combining symptom and quality-of-life variables.
Results: We included 87 patients, 51.7% females and with mean age of 59 years-old [27-87]. At the time of questionnaire collection, patients reported a median of 3 symptoms and prolapse was the most common (85.1%). On proctological examination, most of the patients presented HD Goligher grade II (75.9%). The median SS and EUROHIS-QOL-8 score were 3.0 and 3.5, respectively. The SS identified patients needing ≥ 4 OBT with an AUC = 0.719 (95% CI: [0.61-0.83]) at a cut-off of ≥3 (sensitivity 0.85, specificity 0.47). The Amadora-Sintra model showed superior performance with an AUC = 0.778 (95% CI: [0.66-0.90]), cut-off ≥ 0.105 (sensitivity 0.85, specificity 0.55).
Conclusions: Both the SS and Amadora-Sintra models performed well in identifying patients who didn’t respond to OBT and consequently needed surgery, with the new model standing out for higher performance.