Routine coagulation screening in the management of emergency admission forepistaxis - is it necessary?

The role of routine coagulation studies in the management of patients suffe ring from epistaxis is unclear. In an attempt to address this issue the cas e notes of all emergency admissions for epistaxis to a large Scottish teach ing hospital were retrospectively reviewed over a one-year period. One hund red and forty patients (63 male. 77 female) were admitted between January a nd December 1998. The patients who had coagulation studies were identified and their results analysed. A total of 121 patients (86.4 per cent) had coa gulation studies performed. Of these, 10 (8.3 per cent) had abnormal result s and all were taking warfarin or a combination of warfarin and aspirin. No other coagulation abnormalities were identified. This study supports the v iew that there does not appear to be a role for routine coagulation studies in patients admitted with epistaxis. The investigation for potential haemo static disorders should be performed when clinically indicated and, if nece ssary, in consultation with the haematology service.