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Nosebleeds Common But Seldom Serious, Study Finds

Most patients hospitalized for heavy bleeds need only minor treatment
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Seasonal changes can also have an impact, an expert explained.

"This is the beginning of nosebleed season, as the weather gets cold and the heated air is on in most people's houses," said Dr. Lisa Liberatore, an ear, nose and throat specialist at the New York Head & Neck Institute at Lenox Hill Hospital in New York City. "We're going to see several patients a day, and I'm sure the emergency room is going to get their fair share of nosebleeds."

People also can suffer nosebleeds if they have taken a blow to the nose, are on a blood-thinning medication or have a cancerous lesion in their nose.

Almost everyone is able to treat their nosebleed themselves, or receive successful outpatient treatment at their doctor's office, an urgent-care clinic or an emergency room, the researchers said. Only 0.2 percent of nosebleeds require hospitalization, they said.

This study used nationwide data provided by hospitals to review the care provided to those hospitalized for a nosebleed. Researchers looked at more than 57,000 patients who were hospitalized for nosebleeds between 2008 and 2010. In all cases reviewed, the nosebleed had occurred spontaneously and for no apparent reason, Villwock said.

About 4.7 percent of patients underwent arterial ligation, a surgical procedure that ties off a blood vessel. Another 3.4 percent underwent embolization, in which a catheter delivers a sealant that closes off the bad blood vessel.

These treatments are both riskier and pricier, the researchers said. Embolization carries a five times greater risk of stroke than nasal packing, with 1.5 percent of people who underwent that procedure suffering a stroke. About 1.3 percent of people died while undergoing arterial ligation, a mortality rate nearly twice as high as that of nasal packing.

At the same time, people receiving embolization paid an average nearly $66,000 for their hospital stay, more than three times the amount charged to people treated with nasal packing. Despite this, embolization patients had average hospital stays about as long as people receiving other types of treatment for nosebleeds.

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