Epidemiology and Management of Pediatric Epistaxis

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ObjectivesThe purpose of this study is to describe the demographics of children undergoing inpatient management of epistaxis and recognize the clinical circumstances that may necessitate embolization or ligation for epistaxis management.Study Design and SettingCross-sectional analysis of a national database.Subjects and MethodsA review of data reported by hospitals in the United States to the Healthcare Cost and Utilization Project Kids’ Inpatient Database with a diagnosis of epistaxis was conducted (International Classification of Diseases, Ninth Revision [ICD-9] code 784.7). The database provides new data every 3 years. The most recent databases, 2006, 2009, and 2012, were reviewed.ResultsA total of 11,366 patients with a diagnosis of epistaxis were identified. The average age was 12 years, and most patients were male (60%). Of the patients who underwent intervention for epistaxis, 704 underwent packing, 119 underwent ligation, and 98 underwent embolization. Transfusion of blood or platelets was highest in the patients undergoing packing only (38%, P < .0001). The lowest average length of stay was for the ligation group with a mean (SD) of 6.95 (14.02) days. Embolization and ligation most frequently occurred in the setting of an urban teaching hospital (95.63% and 73.28%, respectively). For patients who underwent embolization with epistaxis as a secondary diagnosis, benign neoplasm of nasopharynx (58.3%) was the most common primary diagnosis. In those patients who underwent ligation, nasal bone fracture (28.5%) was the most common primary diagnosis.ConclusionThis study highlights that 11,366 patients were treated for epistaxis during 2006, 2009, and 2012, and most patients were treated conservatively.

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