Impact of Anticoagulation Therapy on Healthcare Utilization in Patients With Epistaxis

Epistaxis can occur in individuals on anticoagulants, raising concerns about the potential impact on healthcare utilization. This retrospective analysis aims to compare measures of healthcare utilization of two cohorts: adult epistaxis patients without anticoagulant use compared to adult epistaxis patients on anticoagulants.

A retrospective analysis using TriNetX datasets from 2014 to 2024 compared the outcomes of two cohorts: cohort 1 (18,550 patients) named "Epistaxis without Anticoagulation > 18 years" and cohort 2 (9530 patients) named "Epistaxis with Anticoagulation > 18 years". The populations were matched for demographics, leaving 5480 in each cohort. The following outcomes were measured: subsequent hospital care, Emergency Department (ED) services, hospital observation services, diagnostic radiology procedures of the chest, surgical procedures on the respiratory system, surgical procedures on accessory sinuses, and post-op control of nasal hemorrhage posterior or anterior.

Analyses show Cohort 2 at an increased risk for subsequent hospital care (RR 5.99 [4.31-8.33]), ED services (RR 2.70 [2.39-3.03]), hospital observation services (RR 3.00 [1.81-4.98]), and diagnostic radiology procedures of the chest (RR 3.92 [3.25-4.74]). There was a significant increase in the number of ED services required by cohort 2 (p = 0.019). Cohort 1 was more likely to need control of anterior nasal hemorrhage using simple (p < 0.001) and complex (p < 0.001) methods.

This analysis highlights the potential impact of anticoagulation therapy on healthcare utilization in the management of epistaxis and underscores the importance of careful monitoring and appropriate management strategies for this patient population.

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