1 Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA.
Otolaryngol Head Neck Surg. 2018 Oct;159(4):712-716. doi: 10.1177/0194599818785898. Epub 2018 Jul 10.
Objectives The 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 Setting Cross-sectional analysis of a national database. Subjects and Methods A 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. Results A 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. Conclusion This study highlights that 11,366 patients were treated for epistaxis during 2006, 2009, and 2012, and most patients were treated conservatively.
本研究旨在描述接受住院管理的鼻出血儿童的人口统计学特征,并确定需要栓塞或结扎治疗鼻出血的临床情况。
对美国医院向医疗保健成本和利用项目儿童住院数据库报告的鼻出血数据进行横断面分析(国际疾病分类,第九版[ICD-9]代码 784.7)。该数据库每 3 年提供新数据。对最新的 2006 年、2009 年和 2012 年数据库进行了回顾。
共确定了 11366 例诊断为鼻出血的患者。平均年龄为 12 岁,大多数患者为男性(60%)。接受鼻出血介入治疗的患者中,704 例行填塞,119 例行结扎,98 例行栓塞。仅行填塞的患者输血或血小板的比例最高(38%,P<0.0001)。结扎组的平均住院时间最短,平均(SD)为 6.95(14.02)天。栓塞和结扎最常发生在城市教学医院(分别为 95.63%和 73.28%)。对于因鼻出血为次要诊断而行栓塞的患者,鼻咽良性肿瘤(58.3%)是最常见的主要诊断。对于行结扎的患者,鼻骨骨折(28.5%)是最常见的主要诊断。
本研究表明,2006 年、2009 年和 2012 年共治疗了 11366 例鼻出血患者,大多数患者接受了保守治疗。