Success of Apheresis Platelet Replacement in Patients With Antiaggregant Drug-Associated Epistaxis and Cost Effectiveness Analysis
摘要
This study aimed to prevent surgical complications and reduce costs in epistaxis patients using antiplatelet drugs. While emphasizing the importance of apheresis platelet, which is an option as effective as surgery, we aim to highlight this treatment, which has become a medical taboo due to the risk of thrombosis, although there is no clear opinion in the guidelines. We aimed to overcome this situation by creating an algorithm. This study on epistaxis patients using antiplatelet drugs was conducted retrospectively at a university medical faculty hospital. A treatment algorithm was created to avoid surgery and reduce costs. The opinions of the departments where consultation was requested played a role in dividing the patients into groups. Group 1 patients consisted of patients who underwent platelet apheresis (PA) replacement after departmental consultations for epistaxis control. Group 2 patients consisted of patients who underwent surgical treatment for epistaxis control. The mean cost (Turkish Liras/Currency) of Group 1 patients (2486.6 ± 567, 1750–4000) was statistically significant less as compared to the group 2 patients (5673.8 ± 1982.5, 4000–12000). (p < 0.001) The hospitalization period of Group 1 patients (3.53 ± 1.45 days, 2–8 days) was statistically significant less than Group 2 patients (5.38 ± 1.35 days, 4–10 days). (p < 0.001). In applicable cases for whom necessary consultations are made and there are no serious contraindications, platelet transfusion should come before surgery in the algorithm for posterior epistaxis management in antiaggregant users.