title: Does the continuation of warfarin change management outcomes in epistaxis patients?
abstract: OBJECTIVE
  This study aimed to compare management, readmission rates and length of in-patient stay amongst warfarinised and non-warfarinised patients to ascertain future treatment protocols.
  
  
  METHODS
  A 12-month retrospective review was conducted of ENT epistaxis admissions. Admission details such as length of in-patient stay, clotting profile and management plan were recorded. Comparisons of management and outcome for warfarinised and non-warfarinised patients were made using the Fisher's exact paired t-test.
  
  
  RESULTS
  Of 176 epistaxis patients admitted, 31 per cent were warfarinised, 18 per cent were on another form of anticoagulation or antiplatelet therapy, and 51 per cent were not on any medication that might impose a bleeding risk. The international normalised ratio at admission was high in 13 per cent of warfarinised patients; the remaining patients had therapeutic or sub-therapeutic international normalised ratios and so warfarin was continued. The mean in-patient stay was similar for all cohorts; however, warfarinised patients had a higher readmission rate.
  
  
  CONCLUSIONS
  Warfarinised epistaxis patients may be safely managed without stopping their anticoagulation therapy, provided their international normalised ratio is at therapeutic or sub-therapeutic levels. By continuing regular anticoagulation therapy, warfarinised patients may be discharged without delay.
authors.affiliation: Otolaryngology Department,Torbay Hospital,South Devon Healthcare Trust,Torquay,UK.
authors.forename: S
authors.initials: S
authors.lastname: Bola
authors.affiliation: Otolaryngology Department,Torbay Hospital,South Devon Healthcare Trust,Torquay,UK.
authors.forename: R
authors.initials: R
authors.lastname: Marsh
authors.affiliation: Otolaryngology Department,Torbay Hospital,South Devon Healthcare Trust,Torquay,UK.
authors.forename: S
authors.initials: S
authors.lastname: Braggins
authors.affiliation: Otolaryngology Department,Torbay Hospital,South Devon Healthcare Trust,Torquay,UK.
authors.forename: C
authors.initials: C
authors.lastname: Potter
authors.affiliation: Otolaryngology Department,Torbay Hospital,South Devon Healthcare Trust,Torquay,UK.
authors.forename: S
authors.initials: S
authors.lastname: Hickey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002425:Cautery / Q000379:methods; D004844:Epistaxis / Q000628:therapy*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D014859:Warfarin / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin
keywords: Cost; Epistaxis; Pain; Patient Admission; Patient Discharge; Warfarin