Inpatient Pediatric Epistaxis: Management and Resource Utilization

• Published in: Annals of otology, rhinology & laryngology rhinology & laryngology, 2018-11, Vol.127 (11), p.829-835
• Main Authors: Ni, Jonathan S., Kohn, Jocelyn, Levi, Jessica R.
• Format: Article
• Language: English
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/0003489418797946

Objectives: Epistaxis is a common condition that rarely warrants hospital admission in the pediatric population, making its inpatient management difficult to study. This study aims to use a nationwide database to analyze trends in the treatment of pediatric patients admitted with epistaxis and determine factors impacting total charges. Methods: The latest (2012) version of the Kids’ Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality was used to identify weighted discharges with the primary diagnosis of epistaxis. Information regarding demographics, comorbidities, treatment, hospital burden, and other admission details were obtained. Linear regression was used to analyze factors suspected to increase cost. Results: Among 372 weighted discharges, the mean age was 9.68 years (SD = 5.79), and 60.0% were male. The most common comorbidities were thrombocytopenia, von Willebrand disease, and chronic sinusitis. The majority of admissions with epistaxis (56.7%) did not undergo any procedure to control epistaxis. Mean total charges was $30 208 (SD = $62 683) with a mean length of stay of 2.46 days (SD = 3.31). Independent predictors of increased charges included longer length of stay, admission from the emergency department, and median household income within the third quartile for patients’ ZIP codes. Midwest hospital region independently predicted decreased charges. Having a procedure to control epistaxis did not significantly impact cost. Conclusions: Pediatric epistaxis admissions often do not require long hospital stays or procedural control of the bleed. However, significant charges are incurred treating epistaxis. Awareness of factors impacting these charges can potentially improve resource utilization.