Etiological characteristics and management of patients with epistaxis in Aksaray
Etiological characteristics and management of patients with epistaxis in Aksaray
Aim: Epistaxis is a common condition in humans, particularly in patients with hypertension, and is one of the most common presenting symptoms in ear, nose, and throat emergency consultation. The present study aimed to examine the treatment and hospitalization characteristics of the patients who presented with epistaxis in Aksaray city and to propose an optimized and updated protocol.Material and Methods: The present study retrospectively evaluated 758 patients who presented with epistaxis to the Training and Research Hospital in Aksaray between January 2016 and February 2020. The patients were analyzed in terms of age, sex, seasonal characteristics, hospitalization rates, pathogenesis of epistaxis, sites of bleeding, and treatments.Results: The study included 349 females (46.1%) and 409 males (53.9%); mean patient age was 60.9 ± 9.3 years (range: 3–89 years). The most common comorbidity was hypertension (47.3%), and the most common site of bleeding was the anterior region including the Kiesselbach’s plexus (88.2%). Nasal packing (58.5%) and electrocauterization (29.9%) were performed in most cases.The treatment success was defined as no instance of re-visit by the patients to the hospital due to nasal bleeding within 24 h after the procedure; the treatment was successful in 698 patients (92.1%).Conclusion: Most cases of epistaxis are successfully treated using endoscopic electrocauterization on an outpatient basis. Hospitalization is indicated if surgical intervention, posterior packing, or embolization is required and if deterioration of general condition is observed. The present study proposes an updated protocol optimized for the management of epistaxis.
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- 1. Goljo E, Dang R, Iloreta AM, et al. Cost of management in epistaxis admission: Impact of patient and hospital characteristics. Laryngoscope 2015;125:2642-7.
- 2. Pallin DJ, Chng YM, McKay MP, et al.Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med 2005;46:77-81.
- 3. Purkey MR, Seeskin Z, Chandra R. Seasonal variation and predictors of epistaxis. Laryngoscope 2014;124:2028-33.
- 4. Abrich V, Brozek A, Boyle TR, et al. Risk factors for recurrent spontaneous epistaxis. Mayo Clin Proc 2014;89:1636-43
- 5. Diamond L. Managing epistaxis. Jaapa 2014;27:35-9.
- 6. Beck R, Sorge M, Schneider A, et al. Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Dtsch Arztebl Int 2018;115:12-22.
- 7. Sacks R, Sacks PL, Chandra R. Chapter 3: Epistaxis. Am J Rhinol Allergy 2013;27:9-10.
- 8. Kaygusuz İ, Karlidağ T, Keleş E, ve ark. Hastaneye yatırılarak tedavi edilen 68 epistaksisli hastanın retrospektif analizi. Fırat Tıp Derg. 2004;9:82-5.
- 9. Scaramuzzi N, Walsh RM, Brennan P, et al. Treatment of intractable epistaxis using arterial embolization. Clin Otolaryngol Allied Sci 2001;26:307-9.
- 10. Douglas CM, Tikka T, Broadbent B, et al. Patterns of hospital admission in 54 501 patients with epistaxis over a 20-year period in Scotland, UK. Clin Otolaryngol 2018;43:1465-70
- 11. Chaaban MR, Zhang D, Resto V, et al. Demographic, Seasonal, and Geographic Differences in Emergency Department Visits for Epistaxis. Otolaryngol Head Neck Surg 2017;156:81-6.
- 12. Isezuo SA, Segun-Busari S, Ezunu E, 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;11:379-82.
- 13. Celik T, Iyisoy A, Yuksel UC, et al. A new evidence of end-organ damage in the patients with arterial hypertension: epistaxis? Int J Cardiol 2010;141:105-7.
- 14. Lou Z, Wei H, Lou Z. Identification of bleeding sites and microwave thermal ablation of posterior epistaxis. Acta Otolaryngol 2019;139:70-4.