[Epistaxis and anticoagulation - a medical and economic challenge?]

Abstract

Background: According to recent statistics more and more elderly patients are hospitalized due to epistaxis and need anticoagulation. Aim of the present study was to investigate if it was more complex to treat anticoagulated patients than non-anticoagulated patients, if these patients needed a longer hospital stay and to characterize the study population in terms of the various applied therapeutic methods.

Methods: Retrospective study, collecting clinical data of all in-patients treated between 1.1.2007 to 1.8.2011 at an ENT-Department of an University Clinic due to epistaxis.

Results: Of 656 patients 265 were not anticoagulated, 391 were anticoagulated. The mean patients' age increased statistically significant. Patients without anticoagulation were significantly younger than patients with anticoagulation. The duration of the hospitalization differed significantly between the groups, with the longest for patients treated with warfarin (5.4 days). 71 patients underwent surgical treatment of epistaxis (cautery of the sphenopalatine artery or anterior ethmoid artery).

Conclusion: During the study period an increasing number of more elderly patients needed hospitalization due to epistaxis. The duration of hospitalization differed significantly between the groups, with longer stays for the anticoagulated patients. Currently, treatment of epistaxis patients however is reimbursed independently of the presence of comorbidities or anticoagulation therapy. For the further development of the German DRG System a new split of the epistaxis DRG should be considered.