Warfarin and epistaxis — a case controlled study

Patients anticoagulated with warfarin form a small proportion of thos se admitted with epistaxis annually to ENT units. The authors formed the impression that such patients spend longer in hospital and have more complicated management than controls. A prospective age and sex matched controlled study of 20 consecutive patients admitted with epistaxis whilst anticoagulated was performed. This showed thath these patients spent significantly longer in hospital than cntrols, with an additional expense in the study periold of £10,500 for impatient bed nights alone. The management of these patients is more complicated and these is a subgroup of poorly controlled patients who present most of the problems. A potentioal solution is to improve community warfarin control and to involve general practitioners and haematologist in the re-establishment of warfarin following admission for epistaxis.