Otolaryngology consultation for inpatient adult epistaxis: Epidemiologic and outcome analysis

OBJECTIVES: The purpose of this study was to identify factors associated with primary or recurrent episodes of epistaxis in hospitalized patients admitted for conditions other than epistaxis, and to evaluate the impact of otolaryngology (ENT) consultation on inpatient interventions, length of stay, and readmission rates. METHODS: A cross-sectional retrospective review of adult inpatient admission in which epistaxis occurred between January 2021 and December 2023 was conducted. Patient demographics, admission diagnoses, comorbid conditions, seasonal variation, ENT interventions performed, rebleeding episodes requiring reassessment or readmission, and complications were analyzed. Patients were stratified by whether they received otolaryngologic evaluation. RESULTS: A total of 343 patients (mean age 69.3 years; 176 male, 167 female) were included. Trauma-related epistaxis, supplemental oxygen use, anticoagulant/antiplatelet use, and hypertension were associated with higher consultation rates. Patients evaluated by ENT more frequently received topical treatments including nasal saline and oxymetazoline, as well as procedural interventions such as absorbable and non-absorbable nasal packing. Despite this, inpatient ENT consultation corresponded to conservative (no procedural intervention) management in 90.7% of cases. Seasonal analysis showed higher (27%) presentation in the fall from September to November, but no significant differences in patient demographics, interventions, cause of epistaxis, or outcomes. CONCLUSIONS: ENT consultation in hospitalized patients who develop epistaxis is associated with certain clinical characteristics, although conservative management remains the predominant recommendation. While each patient's care is individualized, we demonstrate that ENT consultation for inpatient episodes of epistaxis is not always indicated. These findings may guide inpatient management and resource planning. LEVEL OF EVIDENCE: III.