Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes

Area of Science:

• Emergency Medicine
• Health Services Research
• Clinical Outcomes

Background:

• Epistaxis (nosebleeds) is a common emergency department (ED) presentation.
• Understanding demographic disparities in ED epistaxis management is crucial for equitable care.
• Previous research has not fully elucidated differences in treatment and outcomes based on patient demographics.

Purpose of the Study:

• To investigate associations between patient demographic characteristics and the management of epistaxis in the emergency department.
• To compare treatment patterns and outcomes for epistaxis across different racial and ethnic groups.
• To identify potential disparities in emergency care for nosebleeds.

Main Methods:

• Retrospective cohort study utilizing the TriNetX US collaborative database.
• Adult patients presenting to the ED with epistaxis were followed for 7 days post-visit.
• Propensity score matching was used to compare Spanish-speaking to English-speaking patients, with further stratification by race and ethnicity.

Main Results:

• Spanish-speaking patients were less likely to receive nasal packing/cautery or diagnostic nasal endoscopy compared to English-speaking patients.
• Black patients received more nasal decongestant spray but less other treatment versus White patients.
• Asian patients had lower rates of nasal packing/cautery but more ED visits; Hispanic patients had lower admission rates and fewer ED visits versus White and non-Hispanic patients, respectively.

Conclusions:

• Demographic factors are associated with nuanced differences in emergency department epistaxis management.
• Spanish-speaking, Black, Asian, and Hispanic patients appear less likely to receive diagnostic procedures and epistaxis control interventions.
• Further research is warranted to explore the underlying reasons for these observed disparities in care.