Surgical management of posterior epistaxis: A changing paradigm

Darrell A. Klotz, Mark R. Winkle, Jeremy Richmon, Arthur S. Hengerer

Research output: Contribution to journalArticle

Abstract

Objective: To demonstrate that surgery, as the initial treatment option for posterior epistaxis, can provide comparable success and complication rates to nonsurgical management with fewer associated costs. Study Design: A retrospective chart review and cost analysis. Methods: Two hundred three consecutive charts were reviewed for patient outcome, complications, and hospitalization time. Average costs were calculated from hospital department and physician fee schedules. Results: Average success rate of all surgical procedures performed for posterior epistaxis was 90%, anterior-posterior packing success was 62%, and embolization success was 75%. The packing-only group had a significantly greater mean hospitalization time (5.29 d) than patients who were treated either surgically (2.1 d) or with embolization (2.6 d). The average per-patient admission charges were, for successful posterior packing, $5136 per patient; for surgical treatment, $3851 per patient; and for embolization, $5697 per patient. Surgery offered a cost savings of $1846 per patient over traditional packing. There was no significant difference in complication rates between the groups. Conclusion: The review suggests that a better success rate, a comparable complication rate, and a cost savings can be achieved with surgical intervention as the first-line treatment for intractable epistaxis when compared with traditional anterior-posterior packing and embolization.

Original languageEnglish (US)
Pages (from-to)1577-1582
Number of pages6
JournalLaryngoscope
Volume112
Issue number9
StatePublished - 2002
Externally publishedYes

Fingerprint

Epistaxis
Cost Savings
Costs and Cost Analysis
Hospitalization
Fee Schedules
Patient Admission
Hospital Departments
Therapeutics
Physicians

Keywords

  • Embolization
  • Epistaxis
  • Nasal packing
  • Nose bleed

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Klotz, D. A., Winkle, M. R., Richmon, J., & Hengerer, A. S. (2002). Surgical management of posterior epistaxis: A changing paradigm. Laryngoscope, 112(9), 1577-1582.

Surgical management of posterior epistaxis : A changing paradigm. / Klotz, Darrell A.; Winkle, Mark R.; Richmon, Jeremy; Hengerer, Arthur S.

In: Laryngoscope, Vol. 112, No. 9, 2002, p. 1577-1582.

Research output: Contribution to journalArticle

Klotz, DA, Winkle, MR, Richmon, J & Hengerer, AS 2002, 'Surgical management of posterior epistaxis: A changing paradigm', Laryngoscope, vol. 112, no. 9, pp. 1577-1582.
Klotz DA, Winkle MR, Richmon J, Hengerer AS. Surgical management of posterior epistaxis: A changing paradigm. Laryngoscope. 2002;112(9):1577-1582.
Klotz, Darrell A. ; Winkle, Mark R. ; Richmon, Jeremy ; Hengerer, Arthur S. / Surgical management of posterior epistaxis : A changing paradigm. In: Laryngoscope. 2002 ; Vol. 112, No. 9. pp. 1577-1582.
@article{346e98aeb3a44034bd4f38548b92a0af,
title = "Surgical management of posterior epistaxis: A changing paradigm",
abstract = "Objective: To demonstrate that surgery, as the initial treatment option for posterior epistaxis, can provide comparable success and complication rates to nonsurgical management with fewer associated costs. Study Design: A retrospective chart review and cost analysis. Methods: Two hundred three consecutive charts were reviewed for patient outcome, complications, and hospitalization time. Average costs were calculated from hospital department and physician fee schedules. Results: Average success rate of all surgical procedures performed for posterior epistaxis was 90{\%}, anterior-posterior packing success was 62{\%}, and embolization success was 75{\%}. The packing-only group had a significantly greater mean hospitalization time (5.29 d) than patients who were treated either surgically (2.1 d) or with embolization (2.6 d). The average per-patient admission charges were, for successful posterior packing, $5136 per patient; for surgical treatment, $3851 per patient; and for embolization, $5697 per patient. Surgery offered a cost savings of $1846 per patient over traditional packing. There was no significant difference in complication rates between the groups. Conclusion: The review suggests that a better success rate, a comparable complication rate, and a cost savings can be achieved with surgical intervention as the first-line treatment for intractable epistaxis when compared with traditional anterior-posterior packing and embolization.",
keywords = "Embolization, Epistaxis, Nasal packing, Nose bleed",
author = "Klotz, {Darrell A.} and Winkle, {Mark R.} and Jeremy Richmon and Hengerer, {Arthur S.}",
year = "2002",
language = "English (US)",
volume = "112",
pages = "1577--1582",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Surgical management of posterior epistaxis

T2 - A changing paradigm

AU - Klotz, Darrell A.

AU - Winkle, Mark R.

AU - Richmon, Jeremy

AU - Hengerer, Arthur S.

PY - 2002

Y1 - 2002

N2 - Objective: To demonstrate that surgery, as the initial treatment option for posterior epistaxis, can provide comparable success and complication rates to nonsurgical management with fewer associated costs. Study Design: A retrospective chart review and cost analysis. Methods: Two hundred three consecutive charts were reviewed for patient outcome, complications, and hospitalization time. Average costs were calculated from hospital department and physician fee schedules. Results: Average success rate of all surgical procedures performed for posterior epistaxis was 90%, anterior-posterior packing success was 62%, and embolization success was 75%. The packing-only group had a significantly greater mean hospitalization time (5.29 d) than patients who were treated either surgically (2.1 d) or with embolization (2.6 d). The average per-patient admission charges were, for successful posterior packing, $5136 per patient; for surgical treatment, $3851 per patient; and for embolization, $5697 per patient. Surgery offered a cost savings of $1846 per patient over traditional packing. There was no significant difference in complication rates between the groups. Conclusion: The review suggests that a better success rate, a comparable complication rate, and a cost savings can be achieved with surgical intervention as the first-line treatment for intractable epistaxis when compared with traditional anterior-posterior packing and embolization.

AB - Objective: To demonstrate that surgery, as the initial treatment option for posterior epistaxis, can provide comparable success and complication rates to nonsurgical management with fewer associated costs. Study Design: A retrospective chart review and cost analysis. Methods: Two hundred three consecutive charts were reviewed for patient outcome, complications, and hospitalization time. Average costs were calculated from hospital department and physician fee schedules. Results: Average success rate of all surgical procedures performed for posterior epistaxis was 90%, anterior-posterior packing success was 62%, and embolization success was 75%. The packing-only group had a significantly greater mean hospitalization time (5.29 d) than patients who were treated either surgically (2.1 d) or with embolization (2.6 d). The average per-patient admission charges were, for successful posterior packing, $5136 per patient; for surgical treatment, $3851 per patient; and for embolization, $5697 per patient. Surgery offered a cost savings of $1846 per patient over traditional packing. There was no significant difference in complication rates between the groups. Conclusion: The review suggests that a better success rate, a comparable complication rate, and a cost savings can be achieved with surgical intervention as the first-line treatment for intractable epistaxis when compared with traditional anterior-posterior packing and embolization.

KW - Embolization

KW - Epistaxis

KW - Nasal packing

KW - Nose bleed

UR - http://www.scopus.com/inward/record.url?scp=0036725134&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036725134&partnerID=8YFLogxK

M3 - Article

C2 - 12352666

AN - SCOPUS:0036725134

VL - 112

SP - 1577

EP - 1582

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 9

ER -