Material and Methods
We carried out a retrospective case series study on academic, tertiary
referral settings. The project was approved by the local University
Audit Committee, all participants’ data were handled complying with the
regulations of University Hospital of Larissa scientific committee and
according to the Helsinki and the Health Insurance Portability and
Accountability (HIPAA). STROBE guideline has been followed in this
study. All cases presenting with epistaxis at the ENT-emergency
department within the period January 2011-May 2015 were identified from
the audit database and the ENT-emergency register.
We specifically identified the cases that we discharged home (the home
group) with nasal packing. We collected demographics, relevant
medications, namely coagulation medication, packing material,
complications and need for admission.
We included in the ‘home group’ patients who underwent nasal packing
with a non-absorbable material. Patients were only admitted in cases of
uncontrolled bleeding (need for surgical intervention), abnormal vital
signs, posterior packing, recurrent epistaxis from the “home packing
group”, haemoglobin <10g/dl, uncontrolled hypertension and
high cardiac risk, and in some cases for social reasons (distance from
hospital, lack of social support). All ‘home patients’ were living
within a 45 minute driving distance to our centre. Written instructions
and contact details were handed out to all patients; these were the
safety criteria for discharging the patients. Patients were reviewed 48
hours later on outpatient settings for packing removal.
The nasal examination and the management including the nasal packing was
performed by the staff of the department of ENT surgery who were
competent dealing with such cases.