We utilized a case control study to determine if novel oral anticoagulants were associated with a higher risk of inpatient epistaxis admission. Adult patients admitted with a principal diagnosis of epistaxis in 2019-2021 were identified as well as a control group of patients matched 1:1 for age, sex, race, and medical comorbidities. For both cohorts, the presence or absence of an oral anticoagulant, classified as vitamin K inhibitors, direct oral anticoagulants (DOAC) or platelet inhibitors, was identified. 158 adult unique inpatient admissions with a principal diagnosis of epistaxis were identified. Vitamin K inhibition was present in 5.7% of cases versus 0.6% of controls ( = 0.02; OR 9.48, range 1.19-75.77), DOACs in 4.4% of cases versus 5.1% of controls ( = 1.0) and platelet inhibitors in 2.5% of cases versus 3.8% of controls ( = 0.75). We concluded vitamin K inhibitors, compared to DOACs and platelet inhibitors, may be associated with higher likelihood of epistaxis admission.
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http://dx.doi.org/10.1002/lio2.1111 | DOI Listing |
Res Pract Thromb Haemost
January 2025
Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Background: The addition of caplacizumab to immune thrombotic thrombocytopenia (iTTP) treatment options has led to a renewed interest in characterizing the epidemiology and risk factors for bleeding in iTTP. Limited data exist on the bleeding risk in iTTP due to systemic underreporting in earlier cohorts.
Objectives: To describe the incidence, patterns, and predictors of bleeding in hospitalized iTTP patients independent of caplacizumab use.
Indian J Otolaryngol Head Neck Surg
December 2024
LaPSCo, Physiological and Psychosocial Stress, Emergency Department, Université Clermont Auvergne, CNRS, CHU, Clermont-Ferrand, Clermont, Ferrand, F-63000 France.
Spontaneous epistaxis is a common cause of emergency department's (ED) visit. Considering ED's overcrowding, it seems interesting to study risk factors of hospitalisation or long length of stay to increase triage's quality. Thus, we performed a prospective analysis to assess average length of stay of patients with spontaneous epistaxis.
View Article and Find Full Text PDFAnn Otol Rhinol Laryngol
November 2024
Department of Ear Nose and Throat Surgery, Poole hospital, University Hospitals Dorset, Poole, UK.
Objective: Current common practice for patients with idiopathic epistaxis which requires nasal packing is to admit as an in-patient for overnight observation. Anecdotally, many patients do not re-bleed, so admissions may be unnecessary. Several factors have been suggested to be associated with an increased risk of re-bleeding, such as hypertension, anticoagulant use, and male gender.
View Article and Find Full Text PDFOtol Neurotol
January 2025
Department of Otology-Neurotology, Michigan Ear Institute, Farmington Hills, Michigan.
Objectives: Balloon dilation eustachian tuboplasty (BDET) has gained popularity as a treatment modality for chronic eustachian tube dysfunction (ETD) in both adults and children. Although its safety and efficacy in the adult population have been well described, very few large-sample studies assessing its safety profile have been performed in the pediatric population. This study serves as a follow-up to a previously published analysis assessing the safety of BDET in the pediatric population.
View Article and Find Full Text PDFRespir Med
November 2024
Department of Internal Medicine, Section on Pulmonary and Critical Care Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, United States; Department of Internal Medicine, Section on Hematology and Oncology, 1 Medical Center Blvd, Winston-Salem, NC, 27157, United States; Department of Anesthesiology, Section on Critical Care Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, United States.
Purpose: Epistaxis in critically ill patients may prevent the use of non-invasive ventilation and impair nasal oxygen delivery. Since the onset of COVID-19, high-flow nasal oxygen has dramatically increased. There is a paucity of literature on characteristics of epistaxis in critically ill, COVID-19 positive patients.
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