Trends in Laboratory Evaluation and Risk Factors for Transfusion Therapy in Pediatric Epistaxis

Area of Science:

• Pediatric Emergency Medicine
• Hematology
• Clinical Pathology

Background:

• Epistaxis is a common pediatric emergency department (ED) presentation.
• Practices for laboratory evaluation and transfusion therapy in pediatric epistaxis vary.
• Understanding these practices is crucial for optimizing patient care.

Purpose of the Study:

• To examine the utilization of laboratory testing and transfusion therapy for pediatric epistaxis in the ED.
• To identify factors associated with laboratory evaluation and transfusion in this patient population.

Main Methods:

• A single-center retrospective study was conducted on children (<21 years) with epistaxis from 2013 to 2023.
• Data on demographics, medical history, laboratory tests (CBC, coagulation), and treatments were extracted.
• Descriptive analyses were performed to identify associated factors.

Main Results:

• Of 944 children, 31.4% underwent laboratory testing, primarily complete blood count (CBC) and coagulation tests.
• Transfusions were given to 4.9% of patients, including blood, platelets, and factor replacement.
• Older age, White race, antiplatelet use, nasal procedures, and vascular malformations were linked to laboratory testing.
• Prolonged/recurrent epistaxis, active bleeding, bleeding disorders, oncological conditions, anticoagulant use, and ED nasal interventions were associated with both testing and transfusion.

Conclusions:

• Laboratory evaluation and transfusions are infrequently employed in pediatric epistaxis cases.
• Specific clinical factors, including bleeding severity, underlying conditions, and interventions, predict increased utilization of these therapies.