Recurrent epistaxis: predicting risk of 30-day readmission, derivation and validation of RHINO-ooze score

Addison, Anne; Paul, Cherish; Kuo, Rachel; Lamyman, A; Martinez‐Devesa, Pablo; Hettige, Roland

doi:10.4193/rhin16.259

Cited by 3 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ICD coding of bleeding in the airways and coagulopathies is mainly found in patients with recurrent epistaxis. Epistaxis is a well-known and a factor difficult to control to prevent unplanned readmission [25]. In contrast to planned readmission, head and neck cancer was not an independent risk factor for unplanned readmission.…”

Section: Discussionmentioning

confidence: 99%

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

et al. 2019

View full text Add to dashboard Cite

PurposeAnalyze associations between patients’ characteristics and treatment factors with 30-day unplanned readmissions in hospitalized otolaryngology patients in the German Diagnosis Related Group (D-DRG) system.MethodsA retrospective cohort study was performed on 15.271 otolaryngology admissions of 12.859 patients in 2015 in Thuringia, Germany. The medical records of the 1173 cases (7.6%) with readmission within 30-days were analyzed in detail.ResultsThe 30-day readmission was planned in 747 cases (4.9%) and was unplanned in 422 cases (2.8%). The median interval between primary and next inpatient treatment was 11 days. The principal diagnosis was the same as during the primary index treatment in 72% of the cases. The most frequent reasons for readmission were: Need for non-surgical therapy (31.2%), need for further surgery (26.3%), post-surgical complaints (16.9%), and recurrence of primary complaints (10.7%). The multivariate analysis revealed that discharge due to patient’s request against medical advice was a strong independent factor with high risk for unplanned readmission (Odds Ratio [OR] = 9.62]; confidence interval [CI] = 2.69–34.48). Surgery at index admission (OR = 3.33; CI = 1.86–5.96) was the second important independent risk factor for unplanned readmission. Unplanned readmission had more frequently a non-surgical treatment at readmission than a surgical treatment (OR = 3.92; CI = 2.24–6.84) and needed more frequently further diagnostics (OR = 2.34; CI = 1.34–4.11). The following index International Classification of Diseases (ICD) categories had the highest risk for unplanned readmission: Injury, poisoning and certain other consequences of external causes, ICD: S00-T98 (OR = 66.67; CI = 15.87–333.33), symptoms, signs, abnormal findings, ill-defined causes, not otherwise classified, ICD: R00-R99 (OR = 62.5; CI = 11.76–333.33), blood forming organ diseases, ICD: D50-D90 (OR = 21.276; CI = 3.508–125), and eye/ ear diseases, ICD: H00-H95 (OR = 12.66; CI = 4.29–37.03).ConclusionsThe causes of unplanned 30-day readmission in German otolaryngology inpatients are multifactorial. Specific patient and treatment characteristics were identified to be targeted with health care interventions to decrease unplanned readmissions.

show abstract

Section: Discussionmentioning

confidence: 99%

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This issue of our Journal contains interesting papers about blocked noses (1)(2)(3)(4) . Nasal obstruction is one of the most common reasons that patients visit their doctors, general practitioners and otorhinolaryngologists alike and has a significant impact on the quality of life of patients (5,6) .…”

Section: Blocked Nosesmentioning

confidence: 99%

“…Another disease that contributes to a significant workload for otolaryngologists and can lead to significant morbidity and rarely mortality is epistaxis. In this issue, Allison et al suggest and validate a predictive scoring tool (RHINO-ooze score) with to identify patients with epistaxis at high risk readmission and to enable risk stratification for possible definitive intervention (4) . The RHINO-ooze scoring tool demonstrated a good specificity and sensitivity in predicting the risk of 30 day readmission in patients with epistaxis and can be used as an adjunct to clinical decision making with regards to timing of operative intervention in order to reduce readmission rates.…”

Section: Blocked Nosesmentioning

confidence: 99%

Blocked noses

Fokkens¹

2017

Rhin

View full text Add to dashboard Cite

Can We Estimate the Recurrence of Epistaxis with Simple Blood Tests?

Bedel¹,

Korkut²,

Karancı³

et al. 2020

J Clin Exp Invest

View full text Add to dashboard Cite

Epistaxis is often treated in the emergency department (ED) and is one of the causes of bleeding that can be successfully managed by physicians. This study aimed to investigate whether there is a relationship between recurrent epistaxis and simple blood parameters (the values of mean platelet volume (MPV) and red cell distribution width (RDW)). Method: This retrospective case-control study was designed at a tier-three ED. The patients were chosen from among those who applied to the ED for epistaxis between 1 January 2018 and 31 December 2018. Demographic data, seasonal application frequency, complete blood count results and clinical findings were retrospectively reviewed on the hospital information record system. The patients were categorized into three groups of recurrent epistaxis, nonrecurrent epistaxis and healthy control groups. Results: 143 epistaxis patients in total including recurrent (n=73) and non-recurrent (n=70) patients were enrolled in this study. The healthy control group was composed of 77 patients. The MPV value was significantly higher in the recurrent epistaxis group than in the nonrecurrent epistaxis group (8.91±1.16, 8.48±1.06, P = 0.006, respectively). In addition, the mean platelet and platecrit values were significantly higher in the non-recurrent epistaxis group than in the recurrent epistaxis group (P = 0.034, P = 0.043, respectively). The high RDW level was found to be statistically significant both in the recurrent and non-recurrent epistaxis groups than in the control group (P < 0.001). The logistic regression analysis concluded that the high MPV value increased epistaxis 1.367 times [OR: 1.367 (0.952-1.963), P = 0.028]. Conclusion: High MPV levels caused an increase in the bleeding tendency in the patients with recurrent epistaxis.

show abstract

Recurrent epistaxis: predicting risk of 30-day readmission, derivation and validation of RHINO-ooze score

Abstract: The RHINO-ooze scoring tool demonstrates good specificity and sensitivity in predicting the risk of 30 day readmission in patients with epistaxis and can be used as an adjunct to clinical decision making with regards to timing of operative intervention in order to reduce readmission rates.

Cited by 3 publications

References 17 publications

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

Blocked noses

Can We Estimate the Recurrence of Epistaxis with Simple Blood Tests?

Contact Info

Product

Resources

About