(A230) Otolaryngology Consultation for Inpatient Adult Epistaxis: Epidemiologic and Outcome Analysis

Introduction: Epistaxis is a common clinical presentation in otolaryngology (ENT [ear, nose, and throat]), with a lifelong incidence of over 60% in the general population. Many treatment modalities and algorithms geared toward acute management in the emergency department have been described. This study aims to determine the impact of ENT consultation for inpatient epistaxis reflected by method of hemostasis required, rate of rebleeding, and complications.

Methods: A cross-sectional retrospective review of 344 inpatient admissions with the associated diagnosis of epistaxis from January 2021 to December 2023 was performed. Patient demographics, admission diagnosis International Classification of Diseases (ICD)-10 category, epistaxis risk factors, interventions, epistaxis recurrence, and complications were analyzed. Patients were stratified by ENT intervention versus no ENT intervention and comorbidities, admission diagnoses, treatments, and outcomes were compared.

Results: A total of 344 patients (56.3% male, mean age 76.2 years) with inpatient epistaxis were included in this study, with 130 (40.7%) having ENT evaluation. The most common admission diagnosis category was pulmonary related, 131 (38.1%). Of those evaluated by ENT, 300 (87.2%) were hemostatic upon evaluation. Oxymetazoline demonstrated significantly decreased risk for ENT intervention (OR 0.41, 95% CI: 0.13-0.894; p = 0.029). There were no significant differences between rebleeding rates and complications for non-ENT intervention and ENT intervention groups (12.1% vs 15.3%; p = .235), respectively.

Conclusions: Inpatients admitted with non-epistaxis diagnoses necessitating ENT evaluation for epistaxis tended to have a pulmonary-related admission diagnosis, comorbid hypertension, and anticoagulation use. ENT management demonstrated no significant difference in recurrence rates or complications. Further prospective studies, such as implementation of an inpatient epistaxis consult algorithm, is encouraged to optimize treatment, improve outcomes, and reduce financial burden associated with unnecessary consultations.