{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:52:04Z","timestamp":1793717524551,"version":"4.6.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To report changes in practice brought about by COVID\u201019 and the implementation of new guidelines, and to explore factors relating to unscheduled re\u2010presentations for patients discharged from the emergency department (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective multicentre national audit over 12\u00a0weeks from 6th April 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>UK secondary care ENT departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult patients with acute epistaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Re\u2010presentation within 10\u00a0days for patients discharged from the ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty three centres from all four UK nations submitted 2631 valid cases. The majority of cases were ED referrals (89.7%, n\u00a0=\u00a02358\/2631). 54.6% were discharged from the ED following ENT review (n\u00a0=\u00a01267\/2322), of whom 19.5% re\u2010presented within 10\u00a0days (n\u00a0=\u00a0245\/1259) and 6.8% were ultimately admitted (n\u00a0=\u00a086\/1259). 46.7% of patients had a non\u2010dissolvable pack inserted by ED prior to referral to ENT (n\u00a0=\u00a01099\/2355). The discharge rates for ED patients and their subsequent re\u2010presentation rates were as follows: non\u2010dissolvable packs, 29.5% discharged (n\u00a0=\u00a0332\/1125), 18.2% re\u2010presented (n\u00a0=\u00a060\/330); dissolvable products, 71.1% discharged (n\u00a0=\u00a0488\/686), 21.8% re\u2010presented (n\u00a0=\u00a0106\/486); cautery only, 89.2% discharged (n\u00a0=\u00a0247\/277), 20.0% re\u2010presented (n\u00a0=\u00a049\/245); and no intranasal intervention, 85.5% discharged (n\u00a0=\u00a0200\/234), 15.2% re\u2010presented (n\u00a0=\u00a030\/198). Univariable logistic regression showed that not being packed by ED, antiplatelet medications, failed cautery and recent epistaxis treatment were significant predictors of re\u2010presentation within 10\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Management of acute epistaxis was notably affected during the initial peak of the pandemic, with a shift towards reduced admissions. This national audit highlights that many patients who may previously have been admitted to hospital may be safely discharged from the ED following acute epistaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13716","type":"journal-article","created":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T09:22:16Z","timestamp":1610788936000},"page":"577-586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Admission avoidance in acute epistaxis: A prospective national audit during the initial peak of the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"46","author":[{"name":"INTEGRATE (The UK ENT Trainee Research Network)","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"NHS Digital.NHS Hospital Episode Statistics in England and Wales;2017."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511700202X"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2606.200516"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2001737"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00425-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22577"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13555"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13542"},{"key":"e_1_2_10_10_1","unstructured":"DaviesE HopkinsC HarriesP et al.COVID\u201019 epistaxis management;2020."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_10_12_1","article-title":"Admission avoidance in tonsillitis and peritonsillar abscess: a prospective national audit during the initial peak of the COVID\u201019 pandemic","author":"INTEGRATE (The UK ENT research trainee network)","year":"2020","journal-title":"Clin Otolaryngol"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6923e1"},{"key":"e_1_2_10_14_1","volume-title":"Where are the patients? 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