WARFARIN AND EPISTAXIS - SHOULD WARFARIN ALWAYS BE DISCONTINUED

The object of this study was to determine whether warfarin could be sa fely continued in patients with epistaxis if the International Normali zed Ratio (INR) was within the suggested therapeutic range. Twenty pat ients on warfarin treatment were compared with controls, matched for a ge and sex. Local measures for the control of epistaxis were undertake n appropriately in all the patients. In the warfarin group 17 patients (85%) did not discontinue warfarin as the INR was within the suggeste d range. There were no additional bleeding complications or failure of epistaxis control due to continuation of warfarin. There was no signi ficant difference in the mean hospital stay between the warfarin and n on-warfarin groups. It is concluded that warfarin can be continued saf ely in patients with epistaxis, in appropriate circumstances, and that the policy of stopping warfarin routinely in all patients with epista sis should be reconsidered.