WARFARIN AND EPISTAXIS - A CASE CONTROLLED-STUDY

Patients anticoagulated with warfarin form a small proportion of those admitted with epistaxis annually to ENT units. The authors formed the impression that such patients spend longer in hospital and have more complicated management than controls. A prospective age and sex matche d controlled study of 20 consecutive patients admitted with epistaxis whilst anticoagulated was performed. This showed that these patients s pent significantly longer in hospital than controls, with an additiona l expense in the study period of 10,500 pound for inpatient bed nights alone. The management of these patients is more complicated and there is a subgroup of poorly controlled patients who present most of the p roblems. A potential solution is to improve community warfarin control and to involve general practitioners and haematologists in the re-est ablishment of warfarin following admission for epistaxis.