title: The Wexham Criteria: defining severe epistaxis to select patients requiring sphenopalatine artery ligation.
abstract: This study aims to provide guidance regarding patient selection and timing of intervention with sphenopalatine artery (SPA) ligation by defining 'severe epistaxis'. An analysis of all patients undergoing SPA ligation (January 2002-2010) was performed. SPA ligation was deemed necessary if at least one of the four identified criteria was fulfilled. The same analysis was also performed on all patients admitted with epistaxis who did not undergo SPA ligation over a 6-month period. All 27 patients who underwent SPA ligation met at least one of the criteria selected. Uncontrolled epistaxis (21/27) was fulfilled most often. In comparison, only 4/71 patients admitted with epistaxis who did not undergo SPA ligation fulfilled any single criterion. All criteria were satisfied in a significantly higher number of cases in the SPA group (p < 0.001) The criteria studied proved helpful in identifying patients admitted to hospital with epistaxis who had failed conservative measures.
authors.affiliation: Department of ENT, Wexham Park Hospital, Slough, SL2 4HL, UK. drlakhani@doctors.org.uk
authors.forename: Raj
authors.initials: R
authors.lastname: Lakhani
authors.forename: Irfan
authors.initials: I
authors.lastname: Syed
authors.forename: Ali
authors.initials: A
authors.lastname: Qureishi
authors.forename: Nigel
authors.initials: N
authors.lastname: Bleach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000601:surgery; D004844:Epistaxis / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D008026:Ligation; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013101:Sphenoid Sinus / Q000098:blood supply* / Q000601:surgery; D016896:Treatment Outcome