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Epidemiological characteristics of pediatric epistaxis presenting to the emergency department
Sophie Shay1, Nina L Shapiro1, Neil Bhattacharyya2
1Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 550, Los Angeles, CA 90095, USA.
Insights
Most pediatric epistaxis cases in the emergency department do not require procedures. Socioeconomic and racial disparities may influence emergency care access for children with nosebleeds.
Area of Science:
- Pediatric Emergency Medicine
- Epidemiology
- Health Services Research
Background:
- Epistaxis is a common pediatric emergency department complaint.
- Understanding the epidemiology of pediatric epistaxis is crucial for resource allocation and care optimization.
Purpose of the Study:
- To investigate the epidemiological characteristics of pediatric epistaxis in emergency departments.
- To examine demographic, socioeconomic, and racial factors associated with pediatric epistaxis presentations and management.
Main Methods:
- A cross-sectional study utilizing national emergency department databases from four states in 2010.
- Analysis of 18,745 pediatric epistaxis cases (age <18 years).
- Examination of associated diagnoses, procedures, encounter characteristics, and demographic data.
Main Results:
- Pediatric epistaxis cases were most frequent in spring and summer.
- Children from lower socioeconomic backgrounds and those with Medicaid or no insurance were less likely to undergo epistaxis control procedures.
- White children were more likely to receive procedures compared to minority children.
Conclusions:
- The majority of pediatric epistaxis presentations are uncomplicated and do not necessitate procedural intervention.
- Disparities in procedural intervention based on socioeconomic status and race were observed, suggesting potential overutilization of emergency services for minor cases and possible access to primary care issues.
- This study highlights the need for further research into racial and socioeconomic factors influencing pediatric epistaxis management to address potential healthcare disparities.
Objective:
Investigate the epidemiological characteristics of pediatric epistaxis in the emergency department setting.
Study Design:
Cross-sectional study using national databases.
Methods:
Children (age <18 years) presenting with a diagnosis of epistaxis were extracted from the State Emergency Department Databases for New York, Florida, Iowa, and California for the calendar year 2010. Associated diagnoses, procedures, encounter characteristics, and demographic data were examined.
Results:
There were 18,745 cases of pediatric epistaxis (mean age 7.54 years, 57.4% male). Overall, 6.9% of patients underwent procedures to control epistaxis, of which 93.5% had simple anterior epistaxis control. The distribution of pediatric epistaxis was highest in spring and summer months (p < 0.001). Children from the lowest income quartile comprised a higher proportion of epistaxis presentations (38.8%, p < 0.001), yet were least likely to have an epistaxis control procedure performed (p < 0.001). Most patients had either Medicaid (43.8%) or private insurance (41.3%). Patients with Medicaid and those without healthcare coverage were least likely to undergo an epistaxis control procedure (p < 0.001). White children were more likely to undergo an epistaxis control procedure compared to those of minority backgrounds (p < 0.001).
Conclusions:
Most emergency department presentations of pediatric epistaxis are uninvolved cases that do not require procedural intervention. The overrepresentation of low socioeconomic status patients may suggest an overutilization of emergency services for minor cases of epistaxis, and perhaps a lack of access to primary care providers. This is the first study to evaluate racial and socioeconomic factors in relationship to pediatric epistaxis. Further investigation is needed to better elucidate these potential disparities.
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