Breton Julie, Cambier Sébastien, Adeyemi Oluwaseun J, Allirand Julien, Chatrenet Arthur, Nez François, Saturnin Alexandre, Schmidt Jeannot, Dutheil Frédéric, Bouillon-Minois Jean-Baptiste
Emergency Department, CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France.
Biostatistics Unit (DRCI), CHU Clermont-Ferrand, Clermont-Ferrand, F-63000 France.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5183-5187. doi: 10.1007/s12070-024-04934-y. Epub 2024 Aug 1.
Spontaneous epistaxis is a common cause of emergency department's (ED) visit. Considering ED's overcrowding, it seems interesting to study risk factors of hospitalisation or long length of stay to increase triage's quality. Thus, we performed a prospective analysis to assess average length of stay of patients with spontaneous epistaxis. Secondary objectives were to find putative risk factor of longer length of stay. From February 13th, 2023, to August 31st, 2023, a prospective observational study was performed in five EDs among patients who consult for spontaneous epistaxis. We collected the following time items - arrival, first contact with triage nurse, first medical contact, and discharged or admission time. We also collected sociodemographic, medical history, daily medications, and care in the ED. Among 106 patients, median length of stay in the ED was 144 min. No patient was discharged before 28 min and the longest duration was 625 min (10 h and 25 min. Half epistaxis was already dried up before their arrival in the ED. Main risks factors to long ED length of stay were the hour of admission between midnight and eight am, the need of a blood sample and a consult with an ORL. We did not find any impact of the location of care, hypertension, age, or blood thinners. Half of patient presenting in the ED for spontaneous epistaxis was discharged in 144 min. This duration is significantly prolonged during night shift, if blood was sampled, or if an ORL consult was needed.
自发性鼻出血是急诊科就诊的常见原因。考虑到急诊科的过度拥挤，研究住院或长时间住院的风险因素以提高分诊质量似乎很有意义。因此，我们进行了一项前瞻性分析，以评估自发性鼻出血患者的平均住院时间。次要目标是找出住院时间较长的潜在风险因素。从2023年2月13日至2023年8月31日，在五家急诊科对因自发性鼻出血前来就诊的患者进行了一项前瞻性观察研究。我们收集了以下时间点——到达时间、与分诊护士的首次接触时间、首次医疗接触时间以及出院或入院时间。我们还收集了社会人口统计学信息、病史、日常用药情况以及在急诊科接受的治疗。在106名患者中，在急诊科的中位住院时间为144分钟。没有患者在28分钟前出院，最长住院时间为625分钟（10小时25分钟）。一半患者在到达急诊科之前鼻出血就已经止住了。导致在急诊科住院时间长的主要风险因素是午夜至上午8点之间入院、需要采集血样以及需要耳鼻喉科会诊。我们没有发现治疗地点、高血压、年龄或血液稀释剂有任何影响。在急诊科因自发性鼻出血就诊的患者中有一半在144分钟内出院。如果是在夜班期间、采集了血样或者需要耳鼻喉科会诊，这个时长会显著延长。
