Objective: Epistaxis is one of the commonest causes of attendance of Otolaryngology emergency rooms. Given its incidence, potential severity and high recurrence rate, a systematic and careful management is mandatory. This work aims to define prognostic factors of epistaxis recurrence.
Material And Methods: Retrospective review of medical records of patients with epistaxis admitted to our emergency department from January 2012 to December 2016. Data of 1005 patients with idiopathic epistaxis were analysed and independent risk factors for recurrence were determined by multiple logistic regression analysis.
Results: Recurrence of epistaxis was found in 303 (30.1%) patients. Patients with recurrent epistaxis were older (p<.001) and more commonly had a history of hypertension (p=.001) and antiplatelet (p=.048) and anticoagulant (p=.001) use than those with episodic epistaxis. Age (adjusted OR 1.21, 95%CI 1.08-1.32, p=.003) and anticoagulant use (adjusted OR 2.68, 95%CI 1.94-3.70, p=.009) were predictors of increased risk of recurrent epistaxis. Gender, alcohol abuse, medical history, active bleeding at admission, unidentified bleeding point or treatment modalities were not associated with recurrence.
Conclusion: Age and use of anticoagulation drugs were risk factors for recurrence of epistaxis. None of the previously described risk factors for episodic epistaxis were found to increase the risk of recurrence. Knowledge of factors involved in recurrence might provide important information for assessment and management of increased risk patients.
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http://dx.doi.org/10.1016/j.otorri.2019.05.003 | DOI Listing |
Sci Rep
December 2024
Department of Otolaryngology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 45 Taizhou Rd, Guangling District, Yangzhou, 225001, China.
This study investigated the frequency of idiopathic epistaxis onset and its severity relative to the time of day. Idiopathic epistaxis was defined as epistaxis in the emergency department, with no epistaxis diagnosis in any hospital 12 months before incident epistaxis. The timing of epistaxis onset was divided into four categories: morning (6:01-12:00), afternoon (12:01-18:00), evening (18:01-24:00), and overnight (00:01-6:00).
View Article and Find Full Text PDFAnn Otol Rhinol Laryngol
November 2024
Department of Ear Nose and Throat Surgery, Poole hospital, University Hospitals Dorset, Poole, UK.
Objective: Current common practice for patients with idiopathic epistaxis which requires nasal packing is to admit as an in-patient for overnight observation. Anecdotally, many patients do not re-bleed, so admissions may be unnecessary. Several factors have been suggested to be associated with an increased risk of re-bleeding, such as hypertension, anticoagulant use, and male gender.
View Article and Find Full Text PDFSemin Thromb Hemost
June 2024
Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan.
BMJ Case Rep
May 2024
Trinity Health Grand Rapids, Grand Rapids, Michigan, USA.
Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disorder caused by uncontrolled activation of the immune system, leading to phagocytosis of blood cells and cytokine storm. HLH can manifest in childhood due to a genetic mutation, but in adults HLH arises secondary to viral infections, autoimmune diseases or neoplastic processes. The most common viral infections associated with HLH are Epstein-Barr virus (EBV) and cytomegalovirus (CMV).
View Article and Find Full Text PDFPediatr Emerg Care
July 2024
From the Department of Otolaryngology, Head and Neck Surgery, Shaare-Zedek Medical Center, The Hebrew University.
Objectives: Epistaxis is an emergency medical condition that sometimes requires admission to the emergency department. Pediatric epistaxis differs from epistaxis in the older population in terms of etiology, severity, and management. Our objective was to identify the distinctive features of pediatric epistaxis and determine the appropriate management.
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