title: Discomfort and costs in epistaxis treatment.
abstract: Epistaxis is a very common ENT event. Apart from the effectiveness of the different treatment options, the discomfort and the financial burden are of great importance. It has been the aim of this study to obtain data regarding the discomfort/pain of the epistaxis treatments and to calculate the financial burden. During the period between April 2010 and July 2011 epistaxis patients at our hospital had the opportunity to rate the discomfort/pain they experienced during their treatment on a 0-10 VAS scale. The costs of epistaxis treatments were calculated in an extended cohort. 84 VAS scores in 61 patients were acquired and the costs of treatment were calculated in 96 patients. The lowest VAS scores were found in chemical and electric coagulation with 1.5 and 2.0, respectively, followed by surgery (3.0), Rapid Rhino packing (6.0) and balloon pack (7.5). The costs of treatments depended on whether the treatment was in an out- or inpatient setting. Surgery was not significantly more expensive than packing methods in the inpatient setting. Anterior epistaxis could be managed by local coagulation with an acceptable impact/cost ratio. At our institution, surgery was the most cost effective and the least troublesome procedure in posterior bleedings, preceded by Rapid Rhino packing if required.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Frauenklinikstrasse 24, 8091 Zürich, Switzerland. georgios.nikolaou@usz.ch
authors.forename: Georgios
authors.initials: G
authors.lastname: Nikolaou
authors.forename: David
authors.initials: D
authors.lastname: Holzmann
authors.forename: Michael B
authors.initials: MB
authors.lastname: Soyka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002425:Cautery / Q000191:economics; D004844:Epistaxis / Q000150:complications / Q000191:economics / Q000628:therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006489:Hemostatic Techniques / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome