{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:15:54Z","timestamp":1764260154932,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"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":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Epistaxis is frequently managed with intra\u2010nasal packing devices, traditionally requiring patient admission. Current COVID\u201019 guidelines encourage ambulatory care where possible in this patient cohort. This paper aims to establish the impact of the Clinical Frailty Scale, anticoagulant\/antiplatelet therapeutics and season variation on pre\u2010pandemic admissions to help identify patients suitable for ambulatory epistaxis management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Scottish Regional Health Board<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult patients attending secondary care with epistaxis between March 2019 and March 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Likelihood of epistaxis hospital admission based on Clinical Frailty Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>299 epistaxis presentations were identified, of which 122 (40.8%) required admission. Clinical Frailty Scale of \u22654 had an increased likelihood of admission (OR 3.15 (95% CI:1.94\u20135.16), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). In the majority of presentations (66.2%), patients were taking either an antiplatelet or anticoagulant. Of these presentations, the use of an anticoagulant (OR: 2.00 (95% CI: 1.20\u20103.33), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05 and dual antiplatelet (OR: 2.82 (95% CI: 1.02\u20107.86), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05) demonstrated increased likelihood of admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have shown that frailty increases the risk of admission in adult patients presenting with epistaxis. Clinical Frailty Scale (CFS) could be utilised in risk stratification to identify suitable patients for outpatient management. Patients with CFS \u2264 3 could be considered for outpatient management of their epistaxis. It is likely that patients with CFS \u22654 on anticoagulant or dual antiplatelet will require admission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13765","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T16:52:15Z","timestamp":1616518335000},"page":"983-990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of frailty on epistaxis admission, a retrospective cohort study"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2395-2146","authenticated-orcid":false,"given":"Timothy","family":"Davies","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Alatsatianos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6835-1304","authenticated-orcid":false,"given":"Mohd Afiq Mohd","family":"Slim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Royce","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Whymark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University Hospital Crosshouse Kilmarnock UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2007.01530.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2013.01.008"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13178"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2017.02.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.07.268"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_12_8_1","article-title":"Admission avoidance in acute epistaxis: 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_12_9_1","article-title":"COVID\u201019 epistaxis management","author":"Davies E","year":"2020","journal-title":"ENTUK"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2019.11.002"},{"key":"e_1_2_12_11_1","unstructured":"Public Health Scotland.Scottish intensive care society audit group report on COVID\u201019.2020."},{"key":"e_1_2_12_12_1","unstructured":"MetOffice.When does spring start? 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