Recent Trends in Epistaxis Management in the United States

Abstract

Treatment for epistaxis is highly variable. No significant differences in clinical outcomes were noted between arterial ligation and embolization in the population studied, although embolization resulted in significantly higher costs. Further prospective studies are needed to elucidate variables affecting outcomes of the various treatment options for epistaxis.

The role of oral anticoagulants in epistaxis

“…A comparison of gender distribution with other studies illustrates that our cohort is gender representative of patients presenting with epistaxis [10]. However, in the patient group under 18 years a surprising peak at the age of 15–17 (12 patients = 60%) was seen which is not in concordance with the internationally published two peak age distributions with a first peak around the age of 10 [3].…”

“…But increased coagulopathies in epistaxis patients have been described before [10]. The increased rate of anticoagulant medication correlated with age similar to Bernmüller et al [18].…”

“…Preexisting arterial hypertension was seen as a confounder and has also been associated with epistaxis in multiple publications [10, 21, 22]. Our number is significantly higher compared to epidemiologic studies which demonstrated a 35–40% prevalence for people above the age of 35 although the steep increase of numbers with age has to be taken into account for our cohort [23].…”

Arterial ligation versus embolization in epistaxis management: Counterintuitive national trends

“…In an era of rising healthcare costs, literature has appropriately focused on the cost of various treatment modalities for refractory epistaxis . It has been well documented that endovascular embolization results in greater hospital charges than arterial ligation . Results from the present study are consistent with this finding; embolized epistaxis patients incurred double the amount of total hospital charges compared to ligation patients.…”

A prospective pilot study comparing nasal blood sampling and venipuncture for the assessment of hemoglobin levels and INR

“…The treatment of epistaxis (nosebleed) is routine for otolaryngologists, emergency specialists, and general practitioners. More than half of all adults have had or will experience an episode of nosebleed . This is often harmless and self‐limiting and may be managed by the patient.…”