Patterns of hospital admission in 54 501 patients with epistaxis over a 20‐year period in Scotland, <scp>UK</scp>

Douglas, Catriona; Tikka, Theofano; B, Broadbent; Calder, Nicholas; Montgomery, Jenny

doi:10.1111/coa.13178

Cited by 17 publications

(18 citation statements)

References 19 publications

(18 reference statements)

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“…Decision making for inpatient treatment of epistaxis should be standardized by the use of clinical guidelines to implement strategies to shorten inpatient treatment and to reduce the risk of readmission. There are only a few actual population-based studies on inpatient treatment of epistaxis [2,3,6,14]. Furthermore, there is only one other population-based study on factors influencing readmission for recurrent epistaxis [8].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, several important parameters could not be assessed. Epistaxis is an important mortality factor but mortality could not be estimated [3,15]. A low socioeconomic status and deprivation have been shown as reason for admission, too, but could not be investigated [3].…”

Section: Discussionmentioning

confidence: 99%

“…Epistaxis is a frequent emergency workload in ENT departments and many patients require an inpatient treatment [1][2][3]. As a result of the changing demographic structure, the number of older patients using classical anticoagulants Electronic supplementary material The online version of this article (https ://doi.org/10.1007/s0040 5-020-05875 -2) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

“…The increased use of classical and new anticoagulants seems to increase the incidence of epistaxis [5]. The influence on more severe epistaxis and recurrent bleeding needing inpatient treatment is less clear [3,5]. The majority of data on epistaxis is based on hospital-based analyses.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of data on epistaxis is based on hospital-based analyses. There is a lack of epidemiological, population-based data, especially for complicated recurrent epistaxis with readmission [3,[6][7][8]. Hence, not much is known about the burden for the general population, especially on the burden of severe epistaxis needing inpatient treatment.…”

Section: Introductionmentioning

confidence: 99%

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Hospitalization for epistaxis: a population-based healthcare research study in Thuringia, Germany

Kallenbach

Dittberner

Boeger

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Epistaxis is the most common ENT emergency. The aim was to determine population-based data on severe epistaxis needing inpatient treatment. Methods Retrospective population-based cohort study in the federal state Thuringia in 2016 performed on all 840 inpatients treated for epistaxis in otolaryngology departments (60.1% male, median age: 73 years; 63.9% under anticoagulation). The association between patients' and treatment characteristics and longer inpatient stay (≥ 4 days) as well as readmission for recurrent epistaxis was analyzed using univariable and multivariable statistics. Results The overall incidence of epistaxis needing inpatient treatment was higher for men (42 per 100,000) than for women (28 per 100,000). The highest incidence was reached for men > 85 years (222 per 100,000). Most important independent predictors for longer inpatient stay were localization of the bleeding not in the anterior nose (OR = 2.045; CI = 1.534-2.726), recurrent bleeding during inpatient treatment (OR = 2.142; CI = 1.508-3.042), no electrocoagulation (OR = 2.810; CI = 2.047-3.858), and blood transfusion (OR = 2.731; CI = 1.324-5.635). Independent predictors for later readmission because of recurrent epistaxis were male gender (OR = 1.756; CI = 1.155-2.668), oral anticoagulant use (OR = 1.731; CI = 1.046-2.865), and hereditary hemorrhagic telangiectasia (OR = 13.216; CI 5.102-34.231). Conclusions Inpatient treatment of epistaxis seems to be variable in daily routine needing standardization by clinical guidelines and strategies to shorten inpatient treatment and to reduce the risk of readmission.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hospitalization for epistaxis: a population-based healthcare research study in Thuringia, Germany

Kallenbach

Dittberner

Boeger

et al. 2020

Eur Arch Otorhinolaryngol

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Anti-thrombotics and their impact on inpatient epistaxis management: a tertiary centre experience

et al. 2021

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Introduction Epistaxis represents a massive burden upon NHS resources. Despite being an extremely common reason for emergency ENT admissions, there remains significant variation in its management. Although the evidence base is continually growing, there appears to be a lack of guidance towards managing anti-coagulants and anti-platelet medications and identifying patient-specific outcomes in this setting. Epistaxis has long been associated with a multitude of risk factors but none have shown consistent, direct correlation. Materials and methods We aimed to identify if the use of anti-thrombotic medication was associated with a longer length of hospital admission or conferred a higher requirement for nasal packing, re-packing, surgery or re-admission. We conducted a retrospective analysis of 100 consecutive adult patients admitted over a 6-month period. Statistical analysis was conducted using SPSS software. Results Sixty-five percent of patients were taking anti-thrombotic medication. The variability of admission INR values in those taking warfarin did not relate with any outcome measure. There was no statistical difference between patients taking anti-thrombotic medication and those who do not, with regards to our primary outcome measures. Re-admission rates within 28 days were found to be 13%, with anti-thrombotic medication use and pre-existing cardiovascular disease recognised as commonly encountered risk factors. Three percent of patients required surgical intervention. Eight percent of patients required re-packing, with a Rapid Rhino chosen in all instances. Conclusion The use of anti-thrombotic medication is not associated with increased morbidity or increased rate of complications. Anti-thrombotic usage and more than one medical co-morbidity increase the risk of re-admission within 28 days.

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Prevalence and characteristics of S-point bleeding compared to non S-point bleeding in severe epistaxis

Jeong

Choi

Lee

et al. 2021

Brazilian Journal of Otorhinolaryngology

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Patterns of hospital admission in 54 501 patients with epistaxis over a 20‐year period in Scotland, UK

Abstract: There has been a significant decrease in hospital admissions and length of hospital stay in patients admitted with epistaxis over the past 20 years. There is a significant association with deprivation and epistaxis admission.

Cited by 17 publications

References 19 publications

Hospitalization for epistaxis: a population-based healthcare research study in Thuringia, Germany

Hospitalization for epistaxis: a population-based healthcare research study in Thuringia, Germany

Anti-thrombotics and their impact on inpatient epistaxis management: a tertiary centre experience

Prevalence and characteristics of S-point bleeding compared to non S-point bleeding in severe epistaxis

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