Analysis of Care and Outcomes for Epistaxis Weekend Admissions

Objectives: To study differences in care of patients admitted for epistaxis during the weekend compared to the weekday. Study Design: Retrospective database review. Setting: 2003 to 2014 National Inpatient Sample. Methods: Patients admitted for a primary diagnosis of epistaxis were extracted from the National Inpatient Sample from 2003 to 2014. Univariate and multivariate analyses were applied to assess differences in patient demographics, clinical characteristics, treatment, and outcomes between weekend and weekday admissions. Results: A total of 39,329 cases were included in our study cohort, with 28,458 weekday admissions and 10,892 weekend admissions. There was no significant difference in patient race, gender, insurance status, hospital ownership status, or location between weekend and weekday admissions (p >.05). Most weekend admissions were emergent (82.2%) and were treated with packing (51.8%). Upon performing logistic regression, the likelihood of emergent admission (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.32-1.51, p <.001) and prolonged length of stay (OR 1.11, 95% CI 1.05-1.17, p <.001) was higher for weekend admissions versus weekday admissions. Moreover, odds of packing for epistaxis were significantly higher (OR 1.14, 95% CI 1.09-1.19, p <.001) on the weekend, while odds of ligation (OR 0.88, 95% CI 0.80-0.97, p =.013) and endovascular arterial embolization (OR 0.74, 95% CI 0.65-0.84, p <.001) were lower. There were no significant differences in in-hospital mortality, patient discharge disposition, and total hospital charges (p >.05). Conclusion: Patients primarily admitted for epistaxis over the weekend were more likely to be emergent, experienced prolonged length of stay, and be treated nonoperatively with packing, than weekday admissions. No significant differences in patient insurance or hospital ownership were identified. Level of Evidence: 4.