A Study on 615 Cases of Idiopathic Epistaxis

Abstract

AbstractEpistaxis is one of the most common complaints encountered in the field of otorhinolaryngology. Although hemostasis can be achieved by outpatient treatment in many cases, we have also encountered some difficult-to-treat patients who developed rebleeding or required admission and surgery. We conducted a retrospective analysis of the clinical features of 615 patients with idiopathic epistaxis who were seen at our hospital between 2012 and 2019. We analyzed the patient data and clinical factors associated with epistaxis, including the age, gender, month (season) of visit to our hospital, accompanying systemic complications, bleeding points, procedures used for treatment, history of rebleeding, and history of hospitalization. The patients with epistaxis were predominantly males in their 70s. In regard to the season of presentation, patients with epistaxis were encountered more frequently in the winter than in the summer. Most patients had initially been treated by electrocoagulation. Hypertension was the most common underlying disease. Rebleeding within 7 days after the primary treatment occurred in 11.5% (71/615) of patients. Analysis identified heart and liver disease and antithrombotic drug use as significant risk factors for rebleeding. Although in the overall subject population the bleeding point was most frequently observed in Kiesselbach plexus area, the bleeding point was observed more often in the middle nasal meatus or olfactory cleft in the patients with rebleeding. The most common indication of hospitalization was difficulty in hemostasis, and the bleeding point in most of the hospitalized cases was unknown or in the posterior nasal cavity. The analysis revealed that it may be important to attempt endoscopic hemostasis in patients in whom the bleeding point is identified in the posterior nasal cavity.