The impact of frailty on epistaxis admission, a retrospective cohort study.
Clin Otolaryngol
; 46(5): 983-990, 2021 09.
Article
in English
| MEDLINE | ID: covidwho-1146680
ABSTRACT
OBJECTIVES:
Epistaxis is frequently managed with intra-nasal packing devices, traditionally requiring patient admission. Current COVID-19 guidelines encourage ambulatory care where possible in this patient cohort. This paper aims to establish the impact of the Clinical Frailty Scale, anticoagulant/antiplatelet therapeutics and season variation on pre-pandemic admissions to help identify patients suitable for ambulatory epistaxis management.DESIGN:
Retrospective cohort studySETTING:
Scottish Regional Health BoardPARTICIPANTS:
Adult patients attending secondary care with epistaxis between March 2019 and March 2020. MAIN OUTCOMEMEASURES:
Likelihood of epistaxis hospital admission based on Clinical Frailty Scale.RESULTS:
299 epistaxis presentations were identified, of which 122 (40.8%) required admission. Clinical Frailty Scale of ≥4 had an increased likelihood of admission (OR 3.15 (95% CI1.94-5.16), P < .05). In the majority of presentations (66.2%), patients were taking either an antiplatelet or anticoagulant. Of these presentations, the use of an anticoagulant (OR 2.00 (95% CI 1.20-3.33), P < .05 and dual antiplatelet (OR 2.82 (95% CI 1.02-7.86), P < .05) demonstrated increased likelihood of admission.CONCLUSIONS:
We have shown that frailty increases the risk of admission in adult patients presenting with epistaxis. Clinical Frailty Scale (CFS) could be utilised in risk stratification to identify suitable patients for outpatient management. Patients with CFS ≤ 3 could be considered for outpatient management of their epistaxis. It is likely that patients with CFS ≥4 on anticoagulant or dual antiplatelet will require admission.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Admission
/
Epistaxis
/
Frail Elderly
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Clin Otolaryngol
Journal subject:
Otolaryngology
Year:
2021
Document Type:
Article
Affiliation country:
Coa.13765
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