Faculty Collaboration Database

Epidemiological characteristics of pediatric epistaxis presenting to the emergency department. Int J Pediatr Otorhinolaryngol 2017 Dec;103:121-124

Date

12/12/2017

Pubmed ID

29224751

DOI

10.1016/j.ijporl.2017.10.026

Scopus ID

2-s2.0-85032857890 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

OBJECTIVE: Investigate the epidemiological characteristics of pediatric epistaxis in the emergency department setting.

STUDY DESIGN: Cross-sectional study using national databases.

METHODS: Children (age <18 years) presenting with a diagnosis of epistaxis were extracted from the State Emergency Department Databases for New York, Florida, Iowa, and California for the calendar year 2010. Associated diagnoses, procedures, encounter characteristics, and demographic data were examined.

RESULTS: There were 18,745 cases of pediatric epistaxis (mean age 7.54 years, 57.4% male). Overall, 6.9% of patients underwent procedures to control epistaxis, of which 93.5% had simple anterior epistaxis control. The distribution of pediatric epistaxis was highest in spring and summer months (p < 0.001). Children from the lowest income quartile comprised a higher proportion of epistaxis presentations (38.8%, p < 0.001), yet were least likely to have an epistaxis control procedure performed (p < 0.001). Most patients had either Medicaid (43.8%) or private insurance (41.3%). Patients with Medicaid and those without healthcare coverage were least likely to undergo an epistaxis control procedure (p < 0.001). White children were more likely to undergo an epistaxis control procedure compared to those of minority backgrounds (p < 0.001).

CONCLUSIONS: Most emergency department presentations of pediatric epistaxis are uninvolved cases that do not require procedural intervention. The overrepresentation of low socioeconomic status patients may suggest an overutilization of emergency services for minor cases of epistaxis, and perhaps a lack of access to primary care providers. This is the first study to evaluate racial and socioeconomic factors in relationship to pediatric epistaxis. Further investigation is needed to better elucidate these potential disparities.

Author List

Shay S, Shapiro NL, Bhattacharyya N

Author

Sophie G. Shay MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Cross-Sectional Studies
Databases, Factual
Emergency Service, Hospital
Epistaxis
Female
Humans
Infant
Male
Pediatrics
United States