Epistaxis cost-effectiveness of therapy: Difference between revisions
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{{Epistaxis}} | {{Epistaxis}} | ||
{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Amir Bagheri|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 department|emergency departments]] were [[Discharge|discharged]], [[patients]] were charged on average $1146.21 per visit. | |||
== Cost-effectiveness of Therapy == | |||
* 95.5% of patients with [[epistaxis]] who attend [[Emergency department|emergency departments]] were [[Discharge|discharged]], [[patients]] were charged on average $1146.21 per visit($1473.29 for nasal packing vs $1048.22 otherwise).<ref name="TunkelAnne2020">{{cite journal|last1=Tunkel|first1=David E.|last2=Anne|first2=Samantha|last3=Payne|first3=Spencer C.|last4=Ishman|first4=Stacey L.|last5=Rosenfeld|first5=Richard M.|last6=Abramson|first6=Peter J.|last7=Alikhaani|first7=Jacqueline D.|last8=Benoit|first8=Margo McKenna|last9=Bercovitz|first9=Rachel S.|last10=Brown|first10=Michael D.|last11=Chernobilsky|first11=Boris|last12=Feldstein|first12=David A.|last13=Hackell|first13=Jesse M.|last14=Holbrook|first14=Eric H.|last15=Holdsworth|first15=Sarah M.|last16=Lin|first16=Kenneth W.|last17=Lind|first17=Meredith Merz|last18=Poetker|first18=David M.|last19=Riley|first19=Charles A.|last20=Schneider|first20=John S.|last21=Seidman|first21=Michael D.|last22=Vadlamudi|first22=Venu|last23=Valdez|first23=Tulio A.|last24=Nnacheta|first24=Lorraine C.|last25=Monjur|first25=Taskin M.|title=Clinical Practice Guideline: Nosebleed (Epistaxis)|journal=Otolaryngology–Head and Neck Surgery|volume=162|issue=1_suppl|year=2020|pages=S1–S38|issn=0194-5998|doi=10.1177/0194599819890327}}</ref> | |||
* 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 <ref name="TunkelAnne2020">{{cite journal|last1=Tunkel|first1=David E.|last2=Anne|first2=Samantha|last3=Payne|first3=Spencer C.|last4=Ishman|first4=Stacey L.|last5=Rosenfeld|first5=Richard M.|last6=Abramson|first6=Peter J.|last7=Alikhaani|first7=Jacqueline D.|last8=Benoit|first8=Margo McKenna|last9=Bercovitz|first9=Rachel S.|last10=Brown|first10=Michael D.|last11=Chernobilsky|first11=Boris|last12=Feldstein|first12=David A.|last13=Hackell|first13=Jesse M.|last14=Holbrook|first14=Eric H.|last15=Holdsworth|first15=Sarah M.|last16=Lin|first16=Kenneth W.|last17=Lind|first17=Meredith Merz|last18=Poetker|first18=David M.|last19=Riley|first19=Charles A.|last20=Schneider|first20=John S.|last21=Seidman|first21=Michael D.|last22=Vadlamudi|first22=Venu|last23=Valdez|first23=Tulio A.|last24=Nnacheta|first24=Lorraine C.|last25=Monjur|first25=Taskin M.|title=Clinical Practice Guideline: Nosebleed (Epistaxis)|journal=Otolaryngology–Head and Neck Surgery|volume=162|issue=1_suppl|year=2020|pages=S1–S38|issn=0194-5998|doi=10.1177/0194599819890327}}</ref> | |||
'''Costs for inpatients:'''<ref name="TunkelAnne2020">{{cite journal|last1=Tunkel|first1=David E.|last2=Anne|first2=Samantha|last3=Payne|first3=Spencer C.|last4=Ishman|first4=Stacey L.|last5=Rosenfeld|first5=Richard M.|last6=Abramson|first6=Peter J.|last7=Alikhaani|first7=Jacqueline D.|last8=Benoit|first8=Margo McKenna|last9=Bercovitz|first9=Rachel S.|last10=Brown|first10=Michael D.|last11=Chernobilsky|first11=Boris|last12=Feldstein|first12=David A.|last13=Hackell|first13=Jesse M.|last14=Holbrook|first14=Eric H.|last15=Holdsworth|first15=Sarah M.|last16=Lin|first16=Kenneth W.|last17=Lind|first17=Meredith Merz|last18=Poetker|first18=David M.|last19=Riley|first19=Charles A.|last20=Schneider|first20=John S.|last21=Seidman|first21=Michael D.|last22=Vadlamudi|first22=Venu|last23=Valdez|first23=Tulio A.|last24=Nnacheta|first24=Lorraine C.|last25=Monjur|first25=Taskin M.|title=Clinical Practice Guideline: Nosebleed (Epistaxis)|journal=Otolaryngology–Head and Neck Surgery|volume=162|issue=1_suppl|year=2020|pages=S1–S38|issn=0194-5998|doi=10.1177/0194599819890327}}</ref> | |||
* 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. <ref name="DedhiaDesai2013">{{cite journal|last1=Dedhia|first1=Raj C.|last2=Desai|first2=Shamit S.|last3=Smith|first3=Kenneth J.|last4=Lee|first4=Stella|last5=Schaitkin|first5=Barry M.|last6=Snyderman|first6=Carl H.|last7=Wang|first7=Eric W.|title=Cost-effectiveness of endoscopic sphenopalatine artery ligation versus nasal packing as first-line treatment for posterior epistaxis|journal=International Forum of Allergy & Rhinology|volume=3|issue=7|year=2013|pages=563–566|issn=20426976|doi=10.1002/alr.21137}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Latest revision as of 03:55, 3 November 2020
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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
- 95.5% of patients with epistaxis who attend emergency departments were discharged, patients were charged on average $1146.21 per visit($1473.29 for nasal packing vs $1048.22 otherwise).[1]
- 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
- ↑ 1.0 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.
- ↑ 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.