Descriptive epidemiology of epistaxis in a tertiary care hospital

Authors

  • Melootu Thomas Anie Department of ENT, Amala Institute of Medical Sciences, Thrissur-680555, Kerala, India
  • Gopinatha Menon Arjun Department of ENT, Amala Institute of Medical Sciences, Thrissur-680555, Kerala, India
  • Chakramakal Joseph Andrews Department of ENT, Amala Institute of Medical Sciences, Thrissur-680555, Kerala, India
  • Arayamparambil Rajagopalan Vinayakumar Department of ENT, Amala Institute of Medical Sciences, Thrissur-680555, Kerala, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20150555

Keywords:

Epistaxis, Trauma, Hypertension, Malignant neoplasm, Etiology, Antiplatelets

Abstract

Background: Epistaxis is recognized as one of the most common otorhinolaryngological emergencies affecting the population worldwide. This study is aimed to find out the common etiological factors and the most common treatment modality in the management of epistaxis in our population.

Methods: A cross sectional study on 110 patients of age 4 to 82 years was done. A detailed history, physical examination and laboratory assessment to rule out the various causes of epistaxis had been done. Details of management of epistaxis in each patient were taken and the data was analysed statistically.

Results: There were 78 males (70.9%) and 32 females (29.1%) with a male to female ratio of 2.4. Epistaxis was found to be more prevalent in the elderly, above 60 years age (n=25). No significant gender difference observed in the geriatric age group. The commonest cause of epistaxis was trauma (56.4%) followed by hypertension (11.8%) and infection of sinuses (10.9%).  Hypertension (p =0.0001), CAD (p= 0.013) and CKD (p= 0.044) were found to have significant association. Non surgical measures were the main intervention. Among the nonsurgical management, only medical management was needed in 69 cases (62.7%). Most common surgical intervention was open reduction and internal fixation of facial bones in maxillofacial injuries.

Conclusions: Commonest cause of epistaxis was trauma followed by hypertension and infection of sinuses. Systemic factors are the major underlying cause of epistaxis in above 60 year age group. Reducing the incidence of trauma from road transport cases will reduce the incidence of emergency epistaxis.

References

Eziyi JAE, Akinpelu OV, Amusa YB, Eziyi AK. Epistaxis in Nigerians: A 3-year Experience. East Cent Afr J Surg 2009;14:93-98.

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

Ijaduola GTA, Okeowo PA: Pattern of epistaxis in the tropics. Cent Afr J Med 1983; 29:77-80.

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

Varshney S, Saxena RK. Epistaxis: a retrospective clinical study. Indian J Otolaryngol Head Neck Surg 2005; 57:125-129.

Mgbor NC. Epistaxis in Enugu: A 9 year Review. Nig J of otolaryngology 2004;1:11-14.

Huang C, Shu C. Epistaxis: A review of hospitalized patients. Chinese medical journal 2002;65:74-78.

Kaygusuz I, Karlidag T, Keles E, Yalcin S, Alpay HC, Sakallioglu O. Retrospective Analysis of 68 Hospitalized Patients with Epistaxis. Firat Tip Dergisi 2004, 9:82-85.

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

Stell PM. Epistaxis. Clinical Otolaryngology. 1977; 2: 263-73.

Shaheen OH. Arterial epistaxis. J Laryngol Oto. 1975; 89: 17-34.

McGarry GW. Epistaxis. MD thesis, University of Glasgow, 1996.

Wurman LH, Sack GJ, Flannery JV, Lipsman RA. The management of epistaxis. Am J Otolaryngol. 1992; 13:193-209.

Urvashi R, Raizada RM, Chaturvedi VN. Efficacy of conservative treatment modalities used in epistaxis. Indian J Otolaryngol Head Neck Surg 2004;56:21-23.

Nemer AK, Motassim AR. Evaluation of conservative measures in the treatment of epistaxis. Khartoum Medical Journal 2008;1:15-17.

Daudia A, Jaiswal V, Jones NS. Guidelines for the management of idiopathic epistaxis in adults: how we do it. Clin Otolaryngol 2008; 33:607-628.

Awan MS, Ali MM, Hussain T, Mian MY. Management of paediatrics Epistaxis; A prospective study of 100 cases. Professional Med J 2001; 8:226-65.

Feusi B, Holzmann D, Steurer J. Posterior epistaxis: systematic review on the effectiveness of surgical therapies. Rhinology 2005; 43:300-4.

Umapathy N, Quadri A, Skinner DW. Persistent epistaxis: what is the best practice? Rhinology 2005;43:305-8.

Andersen PJ, Kjeldsen AD, Nepper-Rasmussen J. Selective embolization in the treatment of intractable epistaxis. Acta Otolaryngol 2005;125:293-7.

Rodney JS. Epistaxis: A clinical experience. N Engl J Med 2009; 360:784-9.

Biswas D, Wilson H, Mal R. Use of systemic prophylactic antibiotics with anterior nasal packing in England, UK. Clin Otolaryngol 2006; 31:566-567.

Gupta A, Agrawal SR, Sivarajan K, Gupta V. A Microbiological study of anterior nasal packs in epistaxis. Indian J Otolaryngol Head Neck Surg 1999;15:42-6.

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

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Published

2017-02-09

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Original Research Articles