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

• Published in: European archives of oto-rhino-laryngology 2020-06, Vol.277 (6), p.1659-1666
• Main Authors: Kallenbach, Max, Dittberner, Andreas, Boeger, Daniel, Buentzel, Jens, Kaftan, Holger, Hoffmann, Kerstin, Jecker, Peter, Mueller, Andreas, Radtke, Gerald, Guntinas-Lichius, Orlando
• Format: Article
• Language: English
• Subjects: Aged; Cohort Studies; Epistaxis - epidemiology; Epistaxis - therapy; Female; Germany - epidemiology; Head and Neck Surgery; Health Services Research; Hospitalization; Humans; Male; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology; Retrospective Studies; Rhinology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-020-05875-2

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.