Bal Kemal Koray, Balta Ozan, Ismi Onur, Gur Harun, Gorur Kemal, Ozcan Cengiz
Otorhinolaryngology Department, Mersin University Medicine Faculty Hospital, Mersin, Turkey.
Indian J Otolaryngol Head Neck Surg. 2025 Apr;77(4):1775-1781. doi: 10.1007/s12070-025-05399-3. Epub 2025 Mar 1.
This study aimed to prevent surgical complications and reduce costs in epistaxis patients using antiplatelet drugs. While emphasizing the importance of apheresis platelet, which is an option as effective as surgery, we aim to highlight this treatment, which has become a medical taboo due to the risk of thrombosis, although there is no clear opinion in the guidelines. We aimed to overcome this situation by creating an algorithm. This study on epistaxis patients using antiplatelet drugs was conducted retrospectively at a university medical faculty hospital. A treatment algorithm was created to avoid surgery and reduce costs. The opinions of the departments where consultation was requested played a role in dividing the patients into groups. Group 1 patients consisted of patients who underwent platelet apheresis (PA) replacement after departmental consultations for epistaxis control. Group 2 patients consisted of patients who underwent surgical treatment for epistaxis control. The mean cost (Turkish Liras/Currency) of Group 1 patients (2486.6 ± 567, 1750-4000) was statistically significant less as compared to the group 2 patients (5673.8 ± 1982.5, 4000-12000). ( < 0.001) The hospitalization period of Group 1 patients (3.53 ± 1.45 days, 2-8 days) was statistically significant less than Group 2 patients (5.38 ± 1.35 days, 4-10 days). ( < 0.001). In applicable cases for whom necessary consultations are made and there are no serious contraindications, platelet transfusion should come before surgery in the algorithm for posterior epistaxis management in antiaggregant users.
The online version contains supplementary material available at 10.1007/s12070-025-05399-3.
本研究旨在预防使用抗血小板药物的鼻出血患者的手术并发症并降低成本。在强调单采血小板的重要性时，单采血小板是一种与手术同样有效的选择，我们旨在突出这种因血栓形成风险而成为医学禁忌的治疗方法，尽管指南中尚无明确意见。我们旨在通过创建一种算法来克服这种情况。这项针对使用抗血小板药物的鼻出血患者的研究在一所大学医学院附属医院进行了回顾性研究。创建了一种治疗算法以避免手术并降低成本。请求会诊的科室的意见在将患者分组方面发挥了作用。第1组患者包括在科室会诊后接受血小板单采（PA）替代以控制鼻出血的患者。第2组患者包括接受手术治疗以控制鼻出血的患者。第1组患者的平均成本（土耳其里拉/货币）（2486.6±567，1750 - 4000）与第2组患者（5673.8±1982.5，4000 - 12000）相比，在统计学上显著更低。（<0.001）第1组患者的住院时间（3.53±1.45天，2 - 8天）在统计学上显著短于第2组患者（5.38±1.35天，4 - 10天）。（<0.001）。在进行了必要会诊且无严重禁忌症的适用病例中，在抗聚集剂使用者后鼻孔鼻出血管理算法中，血小板输注应先于手术。
在线版本包含可在10.1007/s12070 - 025 - 05399 - 3获取的补充材料。
