FloSeal hemostatic matrix in persistent epistaxis: prospective clinical trial.
Bibliographic record
Abstract
OBJECTIVE: Although most cases of epistaxis are managed conservatively, occasionally they can progress to significant hemorrhage requiring more involved management or surgery. Endoscopic ligation surgery is the current institutional standard of care for patients who fail conservative management. However, surgical ligation requires availability of surgical resources and patients who are able to withstand an anesthetic. This study's objective was to determine the efficacy of FloSeal hemostatic matrix (Baxter Healthcare Corporation, Hayward, CA) in epistaxis refractory to nasal packing. METHODS: A prospective clinical trial was conducted on epistaxis patients whose nasal hemorrhage persisted despite adequate nasal packing by the otolaryngology-head and neck surgery team. Once enrolled, patients are given a trial of intranasal FloSeal hemostatic matrix to abort the epistaxis. Should this fail, patients then proceed with surgical clipping. RESULTS: Our prospective cohort demonstrated significant success in 80% of patients with persistent epistaxis, who would have otherwise been taken to the operating theatre, avoiding the need for further surgical intervention. The majority of enrolled patients with persistent nasal hemorrhage were adequately managed with the hemostatic matrix alone and were discharged from hospital in a timeframe comparable to that of surgical managment. CONCLUSIONS: This study revealed a highly effective tool in the otolaryngologist's management of persistent epistaxis. Given the ease of use, decreased morbidity to the patient, and cost-effectiveness, FloSeal hemostatic matrix could change clinical practice in managing this common condition.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".