Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-18T08:12:14.805Z Has data issue: false hasContentIssue false
  • English
  • Français

Epistaxis and mortality

Published online by Cambridge University Press:  20 November 2018

Integrate (The National ENT Trainee Research Network)
Integrate (The National ENT Trainee Research Network)
Affiliation:
Integrate (The National ENT Trainee Research Network)*
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Epistaxis is a common emergency presentation to ENT. The ‘Epistaxis 2016: national audit of management’ collected prospective data over a 30-day audit window in 113 centres. A 30-day all-cause mortality rate of 3.4 per cent was identified. This study examines in more detail the subgroup of patients who died during the audit period.

Methods

There were 985 eligible patients identified. Of these, 33 patients died within the audit period. World Health Organization bleeding score, Modified Early Warning System score, haemostasis time, source of referral, co-morbidities and cause of death were investigated from the dataset.

Results

Patients who died were more likely to come from a ward environment, have co-existing cardiovascular disease, diabetes or a bleeding diathesis, be on antithrombotic medication, or have received a blood transfusion. Patients did not die from exsanguination.

Conclusion

Epistaxis may be seen as a general marker of poor health and a poor prognostic sign.

Keywords

EpistaxisMortalityClinical AuditHemorrhage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 12 , December 2018 , pp. 1061 - 1066
Copyright
Copyright © JLO (1984) Limited, 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

See Authorship and participation section for full list of collaborators.

Mr J Hardman takes responsibility for the integrity of the content of the paper

References

1NHS Digital. NHS Hospital Episode Statistics in England and Wales. In: http://content.digital.nhs.uk/hes [31 December 2017]Google Scholar
2Lammens, F, Lemkens, N, Laureyns, G, Lemmens, W, Van Camp, L, Lemkens, P. Epidemiology of ENT emergencies. B-ENT 2014;10:87–92Google Scholar
3Integrate (The National ENT Trainee Research Network). Epistaxis 2016: national audit of management. J Laryngol Otol 2017;131:1131–41Google Scholar
4Royal College of Physicians. The National Hip Fracture Database. In: https://www.nhfd.co.uk/ [31 December 2017]Google Scholar
5Office for National Statistics. Mortality rates (qx), principal projection, United Kingdom. In: https://www.ons.gov.uk/file?uri=/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/datasets/mortalityratesqxprincipalprojectionunitedkingdom/2016based/wukprincipal16qx.xls [1 January 2018]Google Scholar
6Integrate (The National ENT Trainee Research Network). The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis. J Laryngol Otol 2017;131:1142–56Google Scholar
7Iqbal, IZ, Jones, GH, Dawe, N, Mamais, C, Smith, ME, Williams, RJ et al. Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1065–92Google Scholar
8Khan, M, Conroy, K, Ubayasiri, K, Constable, J, Smith, ME, Williams, RJ et al. Initial assessment in the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1035–55Google Scholar
9Mcleod, RWJ, Price, A, Williams, RJ, Smith, ME, Smith, M, Owens, D. Intranasal cautery for the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1056–64Google Scholar
10Swords, C, Patel, A, Smith, ME, Williams, RJ, Kuhn, I, Hopkins, C. Surgical and interventional radiological management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1108–30Google Scholar
11Williams, A, Biffen, A, Pilkington, N, Arrick, L, Williams, RJ, Smith, ME et al. Haematological factors in the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1093–107Google Scholar
12Khan, MN, Blake, DM, Vazquez, A, Setzen, M, Baredes, S, Eloy, JA. Epistaxis: the factors involved in determining medicolegal liability. Int Forum Allergy Rhinol 2014;4:76–81Google Scholar
13Woolf, CI, Jacobs, A. Epistaxis mortality: the place of blood transfusion in its prevention. J Laryngol Otol 1961;75:114–22Google Scholar
14American College of Surgeons, Committee on Trauma. Advanced Trauma Life Support for Doctors: ATLS Student Course Manual. Chicago: American College of Surgeons, 2008Google Scholar
15Centers for Disease Control. Work Table I. Deaths from each cause by 5-year age groups, race and sex: United States. In: https://www.cdc.gov/nchs/data/statab/vs00199wktbli.pdf [31 December 2017]Google Scholar