title: [Epistaxis and anticoagulation - a medical and economic challenge?].
abstract: BACKGROUND
  According to recent statistics more and more elderly patients are hospitalized due to epistaxis and need anticoagulation. Aim of the present study was to investigate if it was more complex to treat anticoagulated patients than non-anticoagulated patients, if these patients needed a longer hospital stay and to characterize the study population in terms of the various applied therapeutic methods.
  
  
  METHODS
  Retrospective study, collecting clinical data of all in-patients treated between 1.1.2007 to 1.8.2011 at an ENT-Department of an University Clinic due to epistaxis.
  
  
  RESULTS
  Of 656 patients 265 were not anticoagulated, 391 were anticoagulated. The mean patients' age increased statistically significant. Patients without anticoagulation were significantly younger than patients with anticoagulation. The duration of the hospitalization differed significantly between the groups, with the longest for patients treated with warfarin (5.4 days). 71 patients underwent surgical treatment of epistaxis (cautery of the sphenopalatine artery or anterior ethmoid artery).
  
  
  CONCLUSIONS
  During the study period an increasing number of more elderly patients needed hospitalization due to epistaxis. The duration of hospitalization differed significantly between the groups, with longer stays for the anticoagulated patients. Currently, treatment of epistaxis patients however is reimbursed independently of the presence of comorbidities or anticoagulation therapy. For the further development of the German DRG System a new split of the epistaxis DRG should be considered.
authors.affiliation: HNO-Klinik, Klinikum Frankfurt Höchst GmbH, Frankfurt a. M.
authors.forename: C
authors.initials: C
authors.lastname: Bermüller
authors.affiliation: HNO-Klinik, Universitätsklinikum Ulm.
authors.forename: M
authors.initials: M
authors.lastname: Bender
authors.affiliation: HNO-Klinik, Universitätsklinikum Ulm.
authors.forename: C
authors.initials: C
authors.lastname: Brögger
authors.affiliation: HNO-Klinik, Universitätsklinikum Ulm.
authors.forename: F
authors.initials: F
authors.lastname: Petereit
authors.affiliation: HNO-Klinik, Universitätsklinikum Ulm.
authors.forename: M
authors.initials: M
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D004564:Electrocoagulation / Q000191:economics; D004844:Epistaxis / Q000139:chemically induced* / Q000191:economics* / Q000601:surgery; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012051:Reimbursement Mechanisms / Q000191:economics; D012189:Retrospective Studies; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin