Results
159 patients presented with epistaxis in the pre-implementation period (22.7 per month), and 86 in the post-implementation period (10.8 per month).
In the pre-implementation period, epistaxis terminated with conservative measures only in 83.0% of patients. The remaining 17.0% were packed with non-dissolvable packs in A&E, all of whom were admitted to hospital. In the post-implementation period, 66.3% terminated with conservative measures, 5.8% received non-dissolvable packs, and were admitted, and 27.9% received dissolvable packing (TXA-soaked NasoPore®). 29.2% of those receiving NasoPore® required further packing with non-dissolvable packs and were subsequently admitted. 2 patients packed with NasoPore® re-attended with epistaxis (8.3%), and 3 patients who were discharged following conservative measures re-attended (5.3%). See table 1.
27/159 patients in the pre-implementation group required more than conservative measures (17%), all of these required admission (100%). 29/86 patients in the post-implementation group required more than conservative measures (33.7%). Of these, 12 patients were admitted (41.0%). Therefore, there was a statistically significant (p < 0.0001) reduction of 59.0% in admissions, after discounting those patients managed with conservative measures only.
After including the 2 patients who re-attended and were admitted following NasoPore® with TXA administration, the proportion admitted post-intervention rises to 48.3%. This results in a decrease in admissions of 51.7% in admissions, still statistically significant (p < 0.0001).