The Impact of Frailty on Epistaxis admission, a retrospective cohort study

Davies, Timothy; Alatsatianos, Anton; Slim, Mohd Afiq Mohd; Royce, William; Whymark, Andrew

doi:10.22541/au.160391883.33604347/v1

Cited by 2 publications

(4 citation statements)

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“…In light of these facts, a potential bias in our results should not be overlooked – possibly many DOAC patients were treated in an out‐patient manner and are omitted from this review. Six 7,8,20,21,23,24 from eight included studies reported on in‐ and out‐patients, and here, no significant difference concerning admission rate in the meta‐analysis has been noted ( p = .12, Table 4). Nevertheless, it seems that a plethora of out‐patient data remains unprocessed.…”

Section: Discussionmentioning

confidence: 63%

“…With regards to the rate of admission to hospital as a percentage of all patients seen in the emergency room, data were extracted from six studies 7,8,20,21,23,24 . No statistical significance between the groups could be found (OR = 0.76, 95% CI 0.54 to 1.07, p = .12; Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…After excluding nine duplicates, we further excluded 250 records based on title and abstract, resulting in 27 studies for full text review. After the additional exclusion of 19 studies that did not meet the inclusion criterion (16 studies were one arm or did not have a thorough comparison between the groups of interest and three studies had less than 20 patients in either group [17][18][19] ), eight studies were included in the final meta-analysis 7,8,13,[20][21][22][23][24] (Figure 1).…”

Section: Studyselectionandcharacteristicsmentioning

confidence: 99%

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Direct oral anticoagulants versus vitamin K antagonists in epistaxis patients: A systematic review and meta‐analysis

Stankovic

Hoch

Rudhart

et al. 2021

Clinical Otolaryngology

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Objective Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiological and haematological guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/setting A systematic review and meta‐analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data were analysed and standardised mean difference (SMD) was calculated according to Hedges' g. Dichotomous data were analysed, and the Mantel‐Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main outcome/results A total of eight reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD = −0.22, 95% CI−0.42 to −0.02, p = .03) and a significantly higher rate of posterior bleeding in the VKA group (OR = .39, 95% CI 0.23 to 0.68, p = .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion or surgical intervention (p = .57, .12, .57 and .38 respectively) were found. Conclusion According to this meta‐analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs.

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Section: Discussionmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

Section: Studyselectionandcharacteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Direct oral anticoagulants versus vitamin K antagonists in epistaxis patients: A systematic review and meta‐analysis

Stankovic

Hoch

Rudhart

et al. 2021

Clinical Otolaryngology

View full text Add to dashboard Cite

show abstract

“…With regard to the rate of admission to hospital as a percentage of all patients seen in the emergency room, data was extracted from 6 studies 7,8,20,21,23,24 . No statistical significance between the groups could be found (OR= .76, 95% CI .54 to 1.07, P= .12; Table 4).…”

Section: Admission Rate Meta-analysismentioning

confidence: 99%

Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta-analysis

Stankovic

Hoch²,

Rudhart³

et al. 2021

Preprint

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Objective: Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiologic and hematologic guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/Setting: A systematic review and meta-analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data was analysed and standardized mean difference (SMD) was calculated according to Hedges’ g. Dichotomous data was analysed and the Mantel-Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main Outcome/Results: A total of 8 reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD= -0.22, 95% CI -0.42 to -0.02, P= .03) and a significantly higher rate of posterior bleeding in the VKA group (OR= .39, 95% CI .23 to .68, P= .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion, or surgical intervention (P= .57, .12, .57 and .38 respectively) were found. Conclusion: According to this meta-analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs.

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The Impact of Frailty on Epistaxis admission, a retrospective cohort study

Abstract: This a preprint and has not been peer reviewed. Data may be preliminary.

Cited by 2 publications

References 0 publications

Direct oral anticoagulants versus vitamin K antagonists in epistaxis patients: A systematic review and meta‐analysis

Direct oral anticoagulants versus vitamin K antagonists in epistaxis patients: A systematic review and meta‐analysis

Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta-analysis

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