Analysis of Bleeding Site to Identify Associated Risk Factors of Intractable Epistaxis

Overview

Journal Ther Clin Risk Manag

Publisher Dove Medical Press

Date 2021 Aug 20

PMID 34413648

Citations 3

Authors

Zhenpeng Liao

Jianling Guo

Jiaoping Mi

Wei Liao

Shulin Chen

Yili Huang

Yingxiang Xu

Jun Zhang

Qintai Yang

Haiyu Hong

Affiliations

Soon will be listed here.

Abstract

Introduction: Intractable epistaxis refers to deep occult bleeding and uncontrolled persistent bleeding. Effective treatment can only be implemented if the bleeding site is quickly identified and the underlying disease controlled.

Objective: The relationship between the bleeding site and the pathogenic factors of intractable epistaxis was analyzed to further strengthen the prevention and treatment of intractable epistaxis by outpatient doctors, family doctors and otolaryngologists. Through accurate search and minimally invasive hemostasis, it helped optimize the treatment plan for intractable epistaxis.

Methods: This study retrospectively analyzed the clinical data of 90 patients with intractable epistaxis who were admitted to hospital from January 2016 to December 2017. Chi-square test was used to analyze the relationship between intractable epistaxis site with underlying disease, gender and age.

Results: The distribution of intractable epistaxis was associated with hypertension ( =13.76, =0.017). The incidence of hypertension was the highest in the olfactory sulcus of the middle turbinate region at about 60%. In addition, age was also identified as a factor that affects the distribution of intractable epistaxis ( =21.95, =0.02). The incidence of intractable epistaxis on the vault of inferiornasal meatus region was highest (63%) in young patients. On the other hand, the olfactory sulcus of the middle turbinate region accounted for the highest incidence in the middle-aged and elderly group (66.7%). There was no obvious relation between the bleeding site of intractable epistaxis with diabetes, cardiovascular disease, chronic sinusitis and allergic rhinitis.

Conclusion: The bleeding site of intractable epistaxis is related to hypertension and age. This may improve the identification of the site of intractable epistaxis for timely implementation of treatment and can further strengthen the prevention and treatment of intractable epistaxis in outpatients or family doctors.

Citing Articles

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References

Gomes P, Salvador P, Lombo C, Caselhos S, Fonseca R . Role of age and anticoagulants in recurrent idiopathic epistaxis. Acta Otorrinolaringol Esp (Engl Ed). 2019; 71(3):160-165. DOI: 10.1016/j.otorri.2019.05.003. View

Beck R, Sorge M, Schneider A, Dietz A . Current Approaches to Epistaxis Treatment in Primary and Secondary Care. Dtsch Arztebl Int. 2018; 115(1-02):12-22. PMC: 5778404. DOI: 10.3238/arztebl.2018.0012. View

Boscardini L, Zanetta S, Ballardini G, Angellotti P, Gramatica P, Scotti A . Epistaxis in children under the age of two: possible marker of abuse/neglect? A retrospective study in North-Eastern Piedmont hospitals. Minerva Pediatr. 2013; 65(1):71-5. View

Abrich V, Brozek A, Boyle T, Chyou P, Yale S . Risk factors for recurrent spontaneous epistaxis. Mayo Clin Proc. 2014; 89(12):1636-43. DOI: 10.1016/j.mayocp.2014.09.009. View

van Horn N, Faizy T, Schoenfeld M, Kohlmann P, Broocks G, Haag P . Computed tomography findings in patients with primarily unknown causes of severe or recurrent epistaxis. PLoS One. 2019; 14(8):e0220380. PMC: 6675056. DOI: 10.1371/journal.pone.0220380. View

Chaaban M, Zhang D, Resto V, Goodwin J . Factors influencing recurrent emergency department visits for epistaxis in the elderly. Auris Nasus Larynx. 2017; 45(4):760-764. PMC: 5959769. DOI: 10.1016/j.anl.2017.11.010. View

Min H, Kang H, Choi G, Kim K . Association between Hypertension and Epistaxis: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg. 2017; 157(6):921-927. DOI: 10.1177/0194599817721445. View

Wei W, Lai Y, Zang C, Luo J, Zhu B, Liu Q . A blind area of origins of epistaxis: technical or cognitive?. Eur Arch Otorhinolaryngol. 2018; 275(6):1501-1505. DOI: 10.1007/s00405-018-4983-7. View

Marin E, Watelet J, Gevaert P, Van Zele T . Severe spontaneous epistaxis: retrospective study in a tertiary ENT centre. Eur Arch Otorhinolaryngol. 2019; 276(6):1693-1699. DOI: 10.1007/s00405-019-05392-x. View

10.

Acar B, Yavuz B, Yildiz E, Ozkan S, Ayturk M, Sen O . A possible cause of epistaxis: increased masked hypertension prevalence in patients with epistaxis. Braz J Otorhinolaryngol. 2016; 83(1):45-49. PMC: 9444775. DOI: 10.1016/j.bjorl.2016.01.007. View

11.

Elwany S, Ibrahim A, Soliman A, Bazak R, Ibrahim H . The significance of atherosclerosis in hypertensive patients with epistaxis. J Laryngol Otol. 2018; 132(4):323-326. DOI: 10.1017/S0022215118000221. View

12.

Kallenbach M, Dittberner A, Boeger D, Buentzel J, Kaftan H, Hoffmann K . Hospitalization for epistaxis: a population-based healthcare research study in Thuringia, Germany. Eur Arch Otorhinolaryngol. 2020; 277(6):1659-1666. PMC: 7198635. DOI: 10.1007/s00405-020-05875-2. View

13.

Liu Y, Zheng C, Wei W, Liu Q . Management of intractable epistaxis: endoscopy or nasal packing?. J Laryngol Otol. 2012; 126(5):482-6. DOI: 10.1017/S0022215112000217. View

14.

Corte F, Orfao T, Dias C, Pinto Moura C, Santos M . Risk factors for the occurrence of epistaxis: Prospective study. Auris Nasus Larynx. 2017; 45(3):471-475. DOI: 10.1016/j.anl.2017.07.021. View

15.

Elahi M, Parnes L, Fox A, Pelz D, Lee D . Therapeutic embolization in the treatment of intractable epistaxis. Arch Otolaryngol Head Neck Surg. 1995; 121(1):65-9. DOI: 10.1001/archotol.1995.01890010051009. View

16.

Mangussi-Gomes J, Enout M, Castro T, de Andrade J, Penido N, Kosugi E . Is the occurrence of spontaneous epistaxis related to climatic variables? A retrospective clinical, epidemiological and meteorological study. Acta Otolaryngol. 2016; 136(11):1184-1189. DOI: 10.1080/00016489.2016.1191673. View

17.

Zou Y, Deng Y, Xiao C, Kong Y, Xu Y, Tao Z . Comparison of outcomes between endoscopic surgery and conventional nasal packing for epistaxis in the posterior fornix of the inferior nasal meatus. Pak J Med Sci. 2016; 31(6):1361-5. PMC: 4744282. DOI: 10.12669/pjms.316.8340. View

18.

Khan M, Conroy K, Ubayasiri K, Constable J, Smith M, Williams R . Initial assessment in the management of adult epistaxis: systematic review. J Laryngol Otol. 2017; 131(12):1035-1055. DOI: 10.1017/S0022215117002031. View

19.

Seidel D, Jacob L, Kostev K, Sesterhenn A . Risk factors for epistaxis in patients followed in general practices in Germany. Rhinology. 2017; 55(4):312-318. DOI: 10.4193/Rhin17.105. View

20.

Kikidis D, Tsioufis K, Papanikolaou V, Zerva K, Hantzakos A . Is epistaxis associated with arterial hypertension? A systematic review of the literature. Eur Arch Otorhinolaryngol. 2013; 271(2):237-43. DOI: 10.1007/s00405-013-2450-z. View