Analysis of risk factors in patients admitted with epistaxis

Tabish Maqbool, Sajad Qadri, Showkat Ahmed Showkat, Rauf Ahmed, Kulvinder Singh Mehta


Background: Epistaxis can be classified into anterior and posterior epistaxis. All bleeding occurs as a result of disruption of the intact nasal mucosa, whether due to trauma, inflammation, or neoplasm. Management depends on the severity of the bleeding and its underlying cause.

Methods: This study was done in department of otorhinolaryngology in a tertiary care centre from September 2018 to December 2020. A total of 143 patients were studies. All patients admitted in our department as a case of epistaxis were analysed for the risk factors present in them which could be the cause of epistaxis.

Results: In our study it was seen the risk factor involved in majority of patients was hypertension (70%), followed closely by diabetis mellitis and deranged coagulogram (65%). Chronic kidney disease was an associated risk factor in 64% of patients. All these factors cause microangiopathies which in turn lead to bleeding.

Conclusions: The current study can be taken as indirect evidence that while raised blood pressure is seen in patients with severe epistaxis but in general the diseases associated with microangiopathies.


Epistaxis, Vasculopathy, Microangiopathies

Full Text:



Tabassom A, Cho JJ. Epistaxis. StatPearls Publishing. 2021.

Beck R, Sorge M, Schneider A, Dietz A. Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Dtsch Arztebl Int. 2018;115(1):12-22.

Kasperek ZA, Pollock GF. Epistaxis: an overview. Emerg Med Clin North Am. 2013;31(2):443-54.

Viehweg TL, Roberson JB, Hudson JW. Epistaxis: diagnosis and treatment. J Oral Maxillofac Surg. 2006;64(3):511-8.

Ando Y, Iimura J, Arai S, Arai C, Komori M, Tsuyumu M, et al. Risk factors for recurrent epistaxis: importance of initial treatment. Auris Nasus Larynx. 2014;41(1):41-5.

Middleton PM. Epistaxis. Emerg Med Australas. 2004;16(5-6):428-40.

Rector FT, Nuccio DJ, Alden MA. A comparison of cocaine, oxymetazoline, and saline for nasotracheal intubation. AANA J. 1987;55(1):49-54.

Kucik CJ, Clenney T. Management of epistaxis. Am Fam Physician. 2005;71(2):305-11.

Kotecha B, Fowler S, Harkness P, Walmsley J, Brown P, Topham J. Management of epistaxis: a national survey. Ann R Coll Surg Engl. 1996;78(5):444-6.

Barnes ML, Spielmann PM, White PS. Epistaxis: a contemporary evidence-based approach. Otolaryngol Clin North Am. 2012;45(5):1005-17.

Herkner H, Laggner AN, Mullner M, Formanek M, Bur A, Gamper G, et al. Hypertension in patients presenting with epistaxis. Ann Emerg Med. 2000;35(2):126-30.

Isezuo SA, Segun BS, Ezunu E, Yakubu A, Iseh K, Legbo J, et al. Relationship between epistaxis and hypertension: a study of patients seen in the emergency units of two tertiary health institutions in Nigeria. Niger J Clin Pract. 2008;11(4):379-82.

Byun H, Chung JH, Lee SH, Ryu J, Kim C, Shin JH. Association of Hypertension with the Risk and Severity of Epistaxis. JAMA Otolaryngol Head Neck Surg. 2020;147(1):1-7.

Abrich V, Brozek A, Boyle TR, Chyou PH, Yale SH. Risk factors for recurrent spontaneous epistaxis. Mayo Clin Proc. 2014;89(12):1636-43.

Kawamura M, Fijimoto S, Hisanaga S, Yamamoto Y, Eto T. Incidence, outcome, and risk factors of cerebrovascular events in patients undergoing maintenance hemodialysis. Am J Kidney Dis. 1998;31(6):991-6.