{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:06:25Z","timestamp":1780092385632,"version":"3.54.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"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":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiological and haematological guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/setting<\/jats:title><jats:p>A systematic review and meta\u2010analysis were performed according to the PRISMA 2020\u00a0statement using the PubMed and Cochrane Library databases. Continuous data were analysed and standardised mean difference (SMD) was calculated according to Hedges' g. Dichotomous data were analysed, and the Mantel\u2010Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the <jats:italic>I<\/jats:italic>\n<jats:sup>2<\/jats:sup>\u00a0statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome\/results<\/jats:title><jats:p>A total of eight reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD\u00a0=\u00a0\u22120.22, 95% CI\u22120.42 to \u22120.02, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.03) and a significantly higher rate of posterior bleeding in the VKA group (OR\u00a0=\u00a0.39, 95% CI 0.23 to 0.68, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion or surgical intervention (<jats:italic>p\u00a0<\/jats:italic>=\u00a0.57, .12, .57 and .38 respectively) were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>According to this meta\u2010analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13898","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T12:49:29Z","timestamp":1637671769000},"page":"255-263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Direct oral anticoagulants versus vitamin K antagonists in epistaxis patients: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0105-1489","authenticated-orcid":false,"given":"Petar","family":"Stankovi\u0107","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head\/Neck &amp; Facial Plastic Surgery Sana Kliniken Leipziger Land  Borna Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Hoch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head\/Neck &amp; Facial Plastic Surgery Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Rudhart","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head\/Neck &amp; Facial Plastic Surgery Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Obradovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Centre University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Dagres","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Centre University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-5224","authenticated-orcid":false,"given":"Thomas","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head\/Neck &amp; Facial Plastic Surgery Sana Kliniken Leipziger Land  Borna Germany"},{"name":"Medical Faculty Philipps\u2010University  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002018"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2016.10.001"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26868"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819890327"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2339-2"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-021-01411-1"},{"key":"e_1_2_12_8_1","first-page":"219","article-title":"Novel oral anticoagulation treatment is not associated with recurrent or severe epistaxis","volume":"59","author":"Runggaldier D","year":"2021","journal-title":"Rhinology"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29417"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-05875-2"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-020-00940-y"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001830"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-019-01824-x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_16_1","unstructured":"FDA Approval Dabigatran.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2010\/022512orig1s000toc.cfm. 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