Management of Epistaxis in Patients on Anti-Platelet and/ Or Anticoagulant Medication
Journal Title: Journal of Medical and Dental Science Research (Quest Journals JMDSR) - Year 2017, Vol 4, Issue 1
Abstract
Objective: To analyse necessity to withhold regular anticoagulant and/or antiplatelet medications to control epistaxis by introducing a modified protocol for management of such patients. Method: One hundred and eighteen patients admitted with epistaxis were studied. First audit was a retrospective study to observe current practice. Second audit was carried out as a prospective study over the period of six months following modified treatment algorithm. These audits were compared on the basis of duration of hospital stay, need for surgical intervention, readmissions, re-bleed, drop in INR below target range. Results: In this non-inferiority analysis the main interest is in the lower bound of the 90% confidence interval (CI) since we want to make sure the second audit approach is not much worse than the first audit approach. Conclusion: The outcomes of the second audit were not significantly worse than first audit. As anti-platelet and anticoagulants were continued, we postulate that potential risks associated with stopping these medications (ie.risk of thrombo-embolism) were reduced without compromising epistaxis control.
Authors and Affiliations
Ms. Rupali Sawant
Keywords
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