Appraisal of the Journal Entitled

The Role of Anticoagulants in Epistaxis

By

Heidi Jesse A. Moya

3rd year resident of the Department of ENT-ORL

1. Setting

The project is taking place in a ENT clinic who caters to walk-in runs a 24-h seven-days-a-week
emergency service as well as a walk-in outpatient clinic dedicated to provide emergency
treatment.

2. Population

The project is about all ENT patients who are over 18 years old with epistaxis. The basic premise
of this project is, whether this patients having pre-medications with (new) anticoagulants
experience more serious complications or will experience a more serious disease course when
presenting with epistaxis in the ENT emergency room.

3. Intervention

Most of the participants in the study are taking the classic oral anticoagulants which is around
36.7% and the ration between COACS and NOACS was 3.2:1. In the group of anticoagulated
patients those put on new oral anticoagulants such as Rivaroxaban, which was found most
often as a NOAC in our cohort, did not show more severe courses or Hb-relevant bleedings or
relapses than other anticoagulants although there was a not statistically significant trend
towards recurrent bleeding as well as less serious courses.

4. Comparison:

The project showed tha patient who are taking new oral anticoagulants do not develop increases
risk for rebleeding or relapses in bleeding than other anticoagulants.

5. Evaluation

Ths study talked about few confounders that can alter the results and conclusion of the study.
This, in fact, is a limitation in presenting the pros and cons of patients with new oral
anticoagukants in comparison to those who are taking the classic oral anticoagulants. The authors
should have widended the demographics in choosing their population. Other drugs may be
included in the study.