Epistaxis cost-effectiveness of therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.

Overview

Most of the patients with epistaxis don't need any medical procedure. Nasal compression is the best first option to stop bleeding. 95.5% of patients with epistaxis who attend emergency departments were discharged, patients were charged on average $1146.21 per visit.

Cost-effectiveness of Therapy

  • A study from Canada showed that when first procedures to stop epistaxis fail, and repeated nasal packing performed to stop bleeding, may increase charging patients up to CaD $4046.74 [1]

Costs for inpatients:[1]

  • About 2.24 days stay in hospital with an average cost of $6925 per admission.
  • Renal diseases can increase costs of per admission by $1272.
  • $30,000 for embolization (total charging of admission by $58,967)
  • Surgical ligation ($28,611)
  • It has been reported that in the case of posterior epistaxis, endoscopic sphenopalatine artery ligation at first is cost-saving instead of performing posterior nasal packing. [2]

References

  1. 1.0 1.1 1.2 Tunkel, David E.; Anne, Samantha; Payne, Spencer C.; Ishman, Stacey L.; Rosenfeld, Richard M.; Abramson, Peter J.; Alikhaani, Jacqueline D.; Benoit, Margo McKenna; Bercovitz, Rachel S.; Brown, Michael D.; Chernobilsky, Boris; Feldstein, David A.; Hackell, Jesse M.; Holbrook, Eric H.; Holdsworth, Sarah M.; Lin, Kenneth W.; Lind, Meredith Merz; Poetker, David M.; Riley, Charles A.; Schneider, John S.; Seidman, Michael D.; Vadlamudi, Venu; Valdez, Tulio A.; Nnacheta, Lorraine C.; Monjur, Taskin M. (2020). "Clinical Practice Guideline: Nosebleed (Epistaxis)". Otolaryngology–Head and Neck Surgery. 162 (1_suppl): S1–S38. doi:10.1177/0194599819890327. ISSN 0194-5998.
  2. Dedhia, Raj C.; Desai, Shamit S.; Smith, Kenneth J.; Lee, Stella; Schaitkin, Barry M.; Snyderman, Carl H.; Wang, Eric W. (2013). "Cost-effectiveness of endoscopic sphenopalatine artery ligation versus nasal packing as first-line treatment for posterior epistaxis". International Forum of Allergy & Rhinology. 3 (7): 563–566. doi:10.1002/alr.21137. ISSN 2042-6976.

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