Inpatient management of epistaxis: outcomes and cost.

OBJECTIVE Evaluate treatments for epistaxis. STUDY DESIGN AND SETTING Retrospective review of Nationwide Inpatient Sample (1998-2000). RESULTS A total of 9778 admissions with admitting diagnosis "epistaxis" were identified. Among admissions involving 1 treatment, 454 (9.6%) received arterial ligation, 94 (2.0%) embolization, and 4188 (88.4%) nasal packing. There were no differences in length of stay, transfusions, complications, or deaths between groups (all P > 0.05). Mean total hospital charges were USD 6,282 for the packing group, USD 12,805 for the ligation group, and USD 17,517 for the embolization group; differences between ligation and packing groups, and embolization and packing groups demonstrated significance ( P < 0.05). CONCLUSIONS Nasal packing is used commonly for epistaxis that requires inpatient management. Although embolization and arterial ligation are associated with higher hospital charges, complications, transfusion rates, and lengths of stay are similar. Further studies are needed to quantify other outcome measures, such as recurrence rates and patient quality of life. SIGNIFICANCE Nasal packing is associated with lower hospital charges and similar complication rates as arterial ligation or embolization.