{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:39:31Z","timestamp":1793320771134,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Epistaxis affects approximately 60% of the population over their lifetime. When conservative attempts fail, nasal tampons are often required to stop anterior bleeding. Health economics is critical in our publicly funded system. Determination of cost-effective interventions is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the total cost of Merocel and Rapid Rhino from the perspective of a provincial payer and an academic hospital for the management of anterior epistaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>London Health Sciences Centre emergency department (Victoria and University campus).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients \u226518\u2009years of age presenting with anterior epistaxis. The participants were 67% men and 33% women. Approximately, 63% were on anticoagulant medication, and 35% used an ambulance to arrive at the hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Rapid Rhino or Merocele, which was dependent on the site of presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Rebleed rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The rate of rebleeds with Merocel was 42% (26\/62), whereas it was 24% (4\/17) with Rapid Rhino. The inverse probability weighted regression adjustment results show that patients receiving Rapid Rhino did not have a statistically significant difference in costs per patient ($62.40, 95% CI: \u2212$25.75 to $150.55) from the hospital perspective or the provincial health care payer perspective ($78.25, 95% CI: \u2212$18.38 to $174.89).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>There was no significant difference in cost between Rapid Rhino and Merocel for anterior epistaxis from a hospital or provincial payer perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251321459","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:27:07Z","timestamp":1740104827000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Management of Anterior Epistaxis in the Emergency Department Using Rapid Rhino and Merocel: A Cost Analysis"],"prefix":"10.1177","volume":"54","author":[{"given":"Dhatri","family":"Shukla","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8801-329X","authenticated-orcid":false,"given":"James","family":"Fowler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6190-1425","authenticated-orcid":false,"given":"Taciano","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisira","family":"Sarma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Sowerby","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"bibr1-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2005.11.031"},{"key":"bibr2-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.12.014"},{"key":"bibr3-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23225"},{"issue":"4","key":"bibr4-19160216251321459","volume":"9","author":"Wang J","year":"2014","journal-title":"PLoS One"},{"key":"bibr5-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002055"},{"key":"bibr6-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2005.01019.x"},{"key":"bibr7-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-017-0248-5"},{"issue":"6","key":"bibr8-19160216251321459","first-page":"427","volume":"109","author":"Keane E","year":"2016","journal-title":"Ir Med J"},{"key":"bibr9-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27081"},{"key":"bibr10-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2019.11.001"},{"key":"bibr11-19160216251321459","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-016-0138-2"},{"key":"bibr12-19160216251321459","unstructured":"Ministry of Health and Long Term Care. 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