Epistaxis: a retrospective clinical study

Authors

  • Shaweta . Department of ENT-HNS, Shri Lal Bahadur Shastri Government Medical College, Nerchowk, Himachal Pradesh, India
  • Rajnish Sharma Department of ENT-HNS, Shri Lal Bahadur Shastri Government Medical College, Nerchowk, Himachal Pradesh, India
  • Nisha Sharma Department of ENT-HNS, Shri Lal Bahadur Shastri Government Medical College, Nerchowk, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20212453

Keywords:

Epistaxis, Hypertension, Anticoagulant, Cardiovascular, Trauma, Cauterization

Abstract

Background: Epistaxis is one of the common emergencies in otorhinolaryngology. The aims and objectives of present work were to study incidence of epistaxis, etiological factors responsible for epistaxis and management of epistaxis.

Methods: A retrospective study (February 2019 to March 2020) of patients admitted in department of otorhinolaryngology with complaint of nasal bleeding was done. The study was conducted on 96 patients for the incidence, age and sex relation, etiological factors, clinical findings and treatment methods for epistaxis.

Results: Out of the total 96 cases of epistaxis, 58.3% were males and 41.6% were females. Most of the patients were over 40 years of age. The maximum, 19 (19.79%) were in the age group of 51-60 years and minimum, 2 (2.08%) were in the age group of 90-100 years. In the study of 96 cases, common group in this series was of cardiovascular causes (hypertension, arteriosclerosis, on antiplatelet drugs), 59 cases (61.45%), out of 59 cases, 9 patients were on antiplatelet drugs followed by idiopathic cases 13 (13.54%), trauma 12 (12.5%), 7 cases (7.29%) blood dyscrasias, spur with DNS 3 (3.12%), infection 1 (1.04%), alcoholic liver disease 1 (1.04%). Out of 96 cases, 92 cases (95.8%) responded to nonsurgical methods.

Conclusions: Epistaxis can be seen in any age. Hypertension, trauma and coagulopathy were the most common etiological factors. Anterior nasal packing was the most common treatment method applied to these patients.

References

Sampigethaya S, Cherian E, Pratap D, Mani I, Bhat VS. A clinical study of epistaxis. Int J Otorhino-laryngol Head Neck Surg 2018;4(2):555-8.

Watkinson JC. Epistaxis. In: Ian S Mackay, Bull TR, eds. Rhinology, Scott Brown's Otorhinolaryngology Head and Neck Surgery. 6th ed. Oxford: Butterworth Heinemann; 1998: 942-61.

Pallin DJ, Chng YM, McKay MP, Emond JA, Pelletier AJ, Camargo CA. Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emergen Med. 2005;46(1):77-81.

Schaitkin B, Strauss M, Houck JR, Hershey PA. Epistaxis: Medical versus surgical therapy: A comparison of efficacy, complications, and economic considerations. Laryngoscope. 1987;97(12):1392-6.

Soyka MB, Nikolaou G, Rufibach K, Holzmann D. On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions. Rhinology. 2011;49(4):474-8.

Kuo C. Update on management of epistaxis. West London Med J. 2009;1(1):33-41.

Walker TWM, Macfarlane TV, McGarry GW. The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995-2004. Clin Otolaryngol. 2007;32(5):361-5.

Pond F, Sizeland A. Epistaxis. Strategies for management. Aust Fam Physician. 2000;29(10):933-8.

Mgbor NC. Epistaxis in Enugu: A 9 year review. Nig J Otolaryngol. 2004;1(2):11-4.

Kaygusuz I, Karlidag T, Keles E, Yalcin S, Alpay HC, Sakallioglu O. Retrospective analysis of 68 hospitalized patients with epistaxis. Firat Tip Dergisi. 2004;9(3):82-5.

Jain NK, Kumar A. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in rural setup: a prospective review of 90 cases. International J Sci Res. 2015;4(7):813-8.

Shah WA, Amin P, Nazir F. Epistaxis-etiological profile and treatment outcome at a tertiary care centre. J Evolution Med Dental Sci. 2015;4(30):5204-10.

Bhatta R. Clinical profile of idiopathic epistaxis in a hospital. J Nepal Med Assoc. 2012;52(188):167-71.

Varshney S, Saxena RK. Epistaxis: a retrospective clinical study. Indian J Otolaryngol Head Neck Surg. 2005;57(2):125-9.

Chaiyasate S, Roongrotwattanasiri K, Fooanan S, Sumitsawan Y. Epistaxis in Chiang Mai University Hospital. J Med Assoc Thai. 2005;88(9):1282-6.

Daudia A, Jaiswal V, Jones NS. Guidelines for the management of idiopathic epistaxis in adults: how we do it. Clin Otolaryngol. 2008;33(6):618-20.

Sarhan NA, Algamal AM. Relationship between epistaxis and hypertension: A cause and effect or coincidence? J Saudi Heart Assoc. 2015;27(2):79-84.

Pandey D. A prospective study of clinical profile of patients with epistaxis at secondary level care metro hospital. Asian Pac J Health Sci. 2016;3(2):78-80.

Gilyoma JM, Chalya PL. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Tanzania: a prospective review of 104 cases. BMC Ear Nose Throat Disord. 2011;11:8.

Iseh KR, Muhammad Z. Pattern of epistaxis in Sokoto, Nigeria: a review of 72 cases. Ann Afr Med. 2008;7(3):107-11.

Maurer JJ, Miles M, German WJ. “Triad of unilateral blindness, orbital fractures and massive epistaxis after head injury”; J Neurosurg 1961;18:837.

Rosnagle RS, Yanagisawa EY, Smith HW. Specific vessel ligation for epistaxis: Surgery of 60 cases. Laryngoscope. 1973;83(4):517-25.

Wang L, Vogel DH. Posterior epistaxis: comparison of treatment. Otolaryngol Head Neck Surg. 1981;89:1001-6.

Mosux DA, Tomas M, Kaiser C, Gavilan J. Conservative management of epistaxis. J Laryngol Otol. 1990;104(11):868-70.

Watson MG, Shenoi PM. Drug-induced epistaxis? J R Soc Med. 1990;83(12):162-4.

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Published

2021-06-23

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Original Research Articles