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Epistaxis 2016: national audit of management

  • INTEGRATE (The National ENT Trainee Research Network) (a1)
Abstract
Abstract Background:

Epistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. This national audit of management sought to assess current practice against newly created consensus recommendations and to expand our current evidence base.

Methods:

The management of epistaxis patients who met the inclusion criteria, at 113 registered sites across the UK, was compared with audit standards during a 30-day window. Data were further utilised for explorative analysis.

Results:

Data for 1826 cases were uploaded to the database, representing 94 per cent of all cases that met the inclusion criteria at participating sites. Sixty-two per cent of patients were successfully treated by ENT clinicians within 24 hours. The 30-day recurrent presentation rate across the dataset was 13.9 per cent. Significant event analysis revealed an all-cause 30-day mortality rate of 3.4 per cent.

Conclusion:

Audit findings demonstrate a varying alignment with consensus guidance, with explorative analysis countering some previously well-established tenets of management.

Copyright
Corresponding author
Address for correspondence: Mr Richard Williams, Institute of Naval Medicine, Crescent Rd, Alverstoke, Gosport PO12 2DL, UK E-mail: Richard.williams8@nhs.net
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See Authorship and participation section for full list of collaborators.

Footnotes
References
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1 Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley L, Browne J et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717–24
2 Hopkins C, Browne JP, Slack R, Lund V, Topham J, Reeves B et al. The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis. Clin Otolaryngol 2006;31:390–8
3 NHS Hospital Episode Statistics in England and Wales. In: http://www.hesonline.nhs.uk [16 June 2017]
4 Mehta N, Williams RJ, Smith ME, Hall A, Hardman JC, Cheung L et al. Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives. J Laryngol Otol 2017;131:518–22
5 Integrate (National ENT Trainee Research Network). The British Rhinological Society multidisciplinary consensus recommendations on the hospital management of epistaxis. J Laryngol Otol. In press
6 Khan M, Conroy K, Ubayasiri K, Constable J, Smith ME, Williams RJ et al. Initial assessment in the management of adult epistaxis: systematic review. J Laryngol Otol. In press
7 Mcleod RW, Price A, Williams RJ, Smith ME, Smith M, Owens D. Intranasal cautery for the management of adult epistaxis: systematic review. J Laryngol Otol. In press
8 Iqbal I, Jones HG, Dawe N, Mamais C, Smith ME, Williams RJ et al. Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review. J Laryngol Otol. In press
9 Williams A, Biffen A, Pilkington N, Arrick L, Williams RJ, Smith ME et al. Haematological factors in the management of adult epistaxis: systematic review. J Laryngol Otol. In press
10 Swords C, Patel A, Smith ME, Williams RJ, Kuhn I, Hopkins C. Surgical and interventional radiological management of adult epistaxis: systematic review. J Laryngol Otol. In press
11 General Medical Council. Good Medical Practice. London: GMC, 1998
12 Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified Early Warning Score in medical admissions. QJM 2001;94:521–6
13 Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer 1981;47:207–14
14 Royal College of Physicians. National Hip Fracture Database (NHFD): annual report 2015. In: http://www.nhfd.co.uk/nhfd/nhfd2015reportPR1.pdf [16 June 2017]
15 Soyka MB, Nikolaou G, Rufibach K, Holzmann D. On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions. Rhinology 2011;49:474–8
16 Henderson AH, Larkins A, Repanos C. The use of bipolar electrocautery in adult epistaxis management: using audit of one hundred and twenty-four cases to define a standardised protocol. Clin Otolaryngol 2013;38:554–8
17 Murer K, Ahmad N, Roth BA, Holzmann D, Soyka MB. THREAT helps to identify epistaxis patients requiring blood transfusions. J Otolaryngol Head Neck Surg 2013;42:4
18 Pollice PA, Yoder MG. Epistaxis: a retrospective review of hospitalized patients. Otolaryngol Head Neck Surg 1997;117:4953
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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