Medicine and Health Sciences | Otolaryngology | Otorhinolaryngologic Diseases
Mucosal bleeding is a well-known complication of having a ventricular assist device and commonly presents with epistaxis. Although the frequency of epistaxis as a complication in patients with a ventricular assist device has been documented in the literature, to our knowledge the cost of this complication has not been reported. This case report examines the financial burden of ventricular assist device-associated epistaxis in a single patient from September 2018 to December 2019 using ICD 10 diagnostic codes. The patient was found to have accumulated $138,020 in costs over 38 encounters. This case report not only highlights the recurrent nature and potential high cost of epistaxis in this patient population, but also identifies a target to reduce healthcare spending. Further research is needed to assess whether cheap and simple preventative measures such as nasal hygiene regimen can decrease the frequency and/or severity of epistaxis in the patients with a ventricular assist device.
epistaxis, ventricular assist device, healthcare costs
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Rohe, E. T., Ryan, E. M., Dowdall, J. R., , Jones, D. T. Costs Associated with Recurrent Epistaxis in a Patient with a Ventricular Assist Device. Graduate Medical Education Research Journal. 2020 Dec 09; 2(2).
Figure 1. Proportion of encounter types and total costs associated with encounter types. (A) Proportions of each encounter type. Thirty-nine percent of all encounters over the 16-month period were in the clinic setting. Inpatient hospitalizations accounted for 37% of all encounters, whereas 24% of encounters were in the emergency department. (B) Proportion of total costs by encounter type. Inpatient hospitalizations accounted for 88% of the total costs. Emergency department and clinic encounters made up 8% and 4%, respectively, of total costs accrued over the 16-month period.