Predictive factors for severe epistaxis in a tertiary center of Tunisia.

Introduction: Epistaxis is a prevalent clinical condition that can be associated with significant morbidity and places a considerable burden on the healthcare system.

Aim: To ascertain the prevalence of epistaxis in our center and to identify the predictive factors of severity.

Methods: This is a retrospective cross-sectional analytical study of patients who presented to and/or were admitted for epistaxis at our department of Ear, Nose and Throat (ENT) during the period from January 2015 to December 2022.

Results: A total of 720 patients were included out of a total of 100,378 consultations, resulting in a prevalence of 0.7%. The mean age of the patients was 51.6 years (±18,73 Standard Deviation (SD)) and the sex ratio H/F was 1.43. The majority (87.9%) of cases were benign and treated on an outpatient basis, while 12.1% of patients presented with severe epistaxis and required hospitalization. The median duration of hospitalization was 5 days. The outcome was favourable in 99.4% of cases. Nevertheless, two cases of death due to severe epistaxis complicated by hemorrhagic shock were observed. A multivariate analysis identified several independent factors associated with severe epistaxis. These included male gender, recurrent epistaxis, a history of hematological disorders, the use of anticoagulant therapy, and an increased International Normalized Ratio (INR) level.

Conclusion: These results have made a significant contribution to our understanding of the severity factors associated with epistaxis, enabling a more targeted and personalized approach to prevention and treatment.