Risk Factors of Epistaxis in Rural Denmark: a Cross-sectional Population-based Survey of Data from the Lolland-Falster Health Study

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2024 Jun 24

PMID 38914819

Authors

Lisette Hvid Hovgaard

Casper Gronlund

Preben Homoe

Affiliations

Soon will be listed here.

Abstract

Purpose: Epistaxis is a common condition that affects about 60% of the population in their lifetime, with 6% needing medical attention. Little is known about the epidemiology and risk factors of epistaxis outside the health care system. This study aimed to investigate the prevalence and risk factors of epistaxis in a rural Danish population using data from the Lolland-Falster Health Study (LOFUS).

Methods: We conducted a cross-sectional survey based on data from LOFUS, a household-based, prospective cohort study in the rural provincial area of Lolland-Falster, Denmark. We enrolled 10,065 participants (≥ 50 years) and collected data on demographics, comorbidities, medication, lifestyle factors, and laboratory parameters. Logistic regressions were used to test for correlations between epistaxis and different risk factors.

Results: In total 5.3% of the participants had experienced epistaxis within the past 30 days, and 7.9% had sought medical attention for epistaxis at some point in their lives. We identified several factors that were significantly correlated with increased odds of epistaxis, such as male gender, age group 50-59 years, high BMI (> 25), allergy, diabetes, hypertension, atherosclerosis, angina, and anticoagulant treatment. Excellent or good self-reported health was correlated to significantly lower odds of epistaxis.

Conclusion: This study provides a comprehensive overview of the prevalence and risk factors of epistaxis outside the health care system. Our study suggests that preventive measures targeting these risk factors may reduce the incidence and severity of epistaxis in this population.

References

Krulewitz N, Fix M . Epistaxis. Emerg Med Clin North Am. 2018; 37(1):29-39. DOI: 10.1016/j.emc.2018.09.005. View

Cooper S, Ramakrishnan V . Direct cauterization of the nasal septal artery for epistaxis. Laryngoscope. 2012; 122(4):738-40. DOI: 10.1002/lary.23225. View

Womack J, Kropa J, Jimenez Stabile M . Epistaxis: Outpatient Management. Am Fam Physician. 2018; 98(4):240-245. View

Pallin D, Chng Y, McKay M, Emond J, Pelletier A, Camargo Jr C . Epidemiology of epistaxis in US emergency departments, 1992 to 2001. Ann Emerg Med. 2005; 46(1):77-81. DOI: 10.1016/j.annemergmed.2004.12.014. View

Villwock J, Jones K . Recent trends in epistaxis management in the United States: 2008-2010. JAMA Otolaryngol Head Neck Surg. 2013; 139(12):1279-84. DOI: 10.1001/jamaoto.2013.5220. View

Iqbal I, Jones G, Dawe N, Mamais C, Smith M, Williams R . Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review. J Laryngol Otol. 2017; 131(12):1065-1092. DOI: 10.1017/S0022215117002055. View

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

Purkey M, Seeskin Z, Chandra R . Seasonal variation and predictors of epistaxis. Laryngoscope. 2014; 124(9):2028-33. DOI: 10.1002/lary.24679. View

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

10.

Fishpool S, Tomkinson A . Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK. Ann R Coll Surg Engl. 2012; 94(8):559-62. PMC: 3954281. DOI: 10.1308/003588412X13373405386691. View

11.

Terakura M, Fujisaki R, Suda T, Sagawa T, Sakamoto T . Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study. J Am Soc Hypertens. 2012; 6(4):291-5. DOI: 10.1016/j.jash.2012.05.001. View

12.

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

13.

Jepsen R, Egholm C, Brodersen J, Simonsen E, Grarup J, Cyron A . Lolland-Falster Health Study: Study protocol for a household-based prospective cohort study. Scand J Public Health. 2018; 48(4):382-390. PMC: 7263040. DOI: 10.1177/1403494818799613. View

14.

Egholm C, Packness A, Stokholm J, Rasmussen K, Ellervik C, Simonsen E . Questionnaire development for the Lolland-Falster Health Study, Denmark: an iterative and incremental process. BMC Med Res Methodol. 2020; 20(1):52. PMC: 7055066. DOI: 10.1186/s12874-020-00931-1. View

15.

Bray D, Giddings C, Monnery P, Eze N, Lo S, Toma A . Epistaxis: are temperature and seasonal variations true factors in incidence?. J Laryngol Otol. 2005; 119(9):724-6. DOI: 10.1258/0022215054798032. View

16.

Fantin F, Francesco V, Rossi A, Giuliano K, Marino F, Cazzadori M . Abdominal obesity and subclinical vascular damage in the elderly. J Hypertens. 2009; 28(2):333-9. DOI: 10.1097/HJH.0b013e328333d23c. View

17.

Iantorno M, Campia U, Di Daniele N, Nistico S, Forleo G, Cardillo C . Obesity, inflammation and endothelial dysfunction. J Biol Regul Homeost Agents. 2014; 28(2):169-76. View

18.

Byun H, Chung J, Lee S, Ryu J, Kim C, Shin J . Association of Hypertension With the Risk and Severity of Epistaxis. JAMA Otolaryngol Head Neck Surg. 2020; . PMC: 7489409. DOI: 10.1001/jamaoto.2020.2906. View

19.

Kunz S, Holzmann D, Soyka M . Association of epistaxis with atherosclerotic cardiovascular disease. Laryngoscope. 2018; 129(4):783-787. DOI: 10.1002/lary.27604. View

20.

Soyka M, Rufibach K, Huber A, Holzmann D . Is severe epistaxis associated with acetylsalicylic acid intake?. Laryngoscope. 2009; 120(1):200-7. DOI: 10.1002/lary.20695. View