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One-year all-cause mortality for 338 patients admitted with epistaxis in a large tertiary ENT centre

Published online by Cambridge University Press:  07 May 2019

M J Corr*
Affiliation:
Department of ENT, Royal Hospital for Children, Glasgow,
T Tikka
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
C M Douglas
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
J Marshall
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
*
Author for correspondence: Mr Matthew J Corr, Department of ENT, Royal Hospital for Children, Govan Rd, Glasgow G51 4TF, Scotland, UK E-mail: [email protected]

Abstract

Objective

Epistaxis is the most common ENT emergency. This study aimed to assess one-year mortality rates in patients admitted to a large teaching hospital.

Method

This study was a retrospective case note analysis of all patients admitted to the Queen Elizabeth University Hospital in Glasgow with epistaxis over a 12-month period.

Results

The one-year overall mortality for a patient admitted with epistaxis was 9.8 per cent. The patients who died were older (mean age 77.2 vs 68.8 years; p = 0.002), had a higher Cumulative Illness Rating Scale-Geriatric score (9.9 vs 6.7; p < 0.001) and had a higher performance status score (2 or higher vs less than 2; p < 0.001). Other risk factors were a low admission haemoglobin level (less than 128 g/dl vs 128 g/dl or higher; p = 0.025), abnormal coagulation (p = 0.004), low albumin (less than 36 g/l vs more than 36 g/l; p < 0.001) and longer length of stay (p = 0.046).

Conclusion

There are a number of risk factors associated with increased mortality after admission with epistaxis. This information could help with risk stratification of patients at admission and enable the appropriate patient support to be arranged.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr M J Corr takes responsibility for the integrity of the content of the paper

References

1Petruson, B, Rudin, R. The frequency of epistaxis in a male population sample. Rhinology 1975;13:129–33Google Scholar
2Walker, TW, Macfarlane, TV, McGarry, GW. The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995–2004. Clin Otolaryngol 2007;32:361–5Google Scholar
3Douglas, CM, Tikka, T, Broadbent, B, Calder, N, Montgomery, J. Patterns of hospital admission in 54 501 patients with epistaxis over a 20-year period in Scotland, UK. Clin Otolaryngol 2018;43:1465–70Google Scholar
4Schnell, S, Friedman, SM, Mendelson, DA, Bingham, KW, Kates, SL. The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil 2010;1:614Google Scholar
5Neuburger, J, Currie, C, Wakeman, R. The impact of a national clinician-led audit initiative on care and mortality after hip fracture in England: an external evaluation using time trends in non-audit data. Med Care 2015;53:686–91Google Scholar
6National Institute for Health and Care Excellence (NICE). Hip fracture: management. 2011;CG124Google Scholar
7NHS Health Research Authority. Do I need NHS ERC approval? In: http://www.hra-decisiontools.org.uk/ethics/ [9 October 2018]Google Scholar
8Department of Public Health, Scottish Government. Population of Greater Glasgow and Clyde, 2015. In: https://www.nhsggc.org.uk/media/234486/nhsggc_ph_dphreport2015_population_of_nhsggc.pdf [3 July 2018]Google Scholar
9Miller, MD, Paradis, CF, Houck, PR, Mazumdar, S, Stack, JA, Rifai, AH et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the cumulative illness rating scale. Psychiatry Res 1992;41:237–48Google Scholar
10Moffitt Cancer Center. CIRS-G score calculator. In: https://eforms.moffitt.org/cirsgScore.aspx [30 January 2018]Google Scholar
11National ENT Trainee Research Network. Epistaxis 2016: national audit of management. J Laryngol Otol 2017;131:1131–41Google Scholar
12Fishpool, SJ, Tomkinson, A. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK. Ann R Coll Surg Eng 2012;94:559–62Google Scholar
13Rainsbury, JW, Molony, NC. Clopidogrel versus low-dose aspirin as risk factors for epistaxis. Clin Otolaryngol 2009;34:232–5Google Scholar
14Yaneza, MM, Amiraraghi, N. Epistaxis. Surgery (Oxford) 2018;36:543–52Google Scholar
15Goldwasser, P, Feldman, J. Association of serum albumin and mortality risk. J Clin Epidemiol 1997;50:693703Google Scholar
16Scottish Index of Multiple Deprivation 2016. In: https://www2.gov.scot/Topics/Statistics/SIMD [25 February 2019]Google Scholar