Characteristics and Risk Factors of Recurrent Epistaxis in Geriatric Patients

Abstract

Background and Objectives Recurrent epistaxis requiring emergency department (ED) visits results in increased morbidity in the elderly and associated with high health care costs. This study is to analyze the frequency and characteristics of epistaxis patients in the elderly and to find out the risk factors and effective treatment for recurrent epistaxis. Subjects and Method We studied retrospectively the clinical cases of 977 emergency patients and 155 patients, aged over 65, for the treatment of epistaxis during the last 10 years from January 2008 to January 2018. The group A, comprised of 95 patients (68.29%), was treated with an initial treatment. The group B, which comprised of 60 patients (38.71%), visited for re-bleeding following an initial treatment. Results Patients made 2 to 10 ED visits due to re-bleeding and 32 of the 60 patients (53.5%) visited twice. The electrocauterization was the most common (61.7%) for treatment method during rebleeding, followed by posterior packing (18.3%). The factors that increases the risk of recurrent epistaxis are anticoagulants, posterior epistaxis, anterior packing, inefficient ED packing. There was no correlation between comorbidities and rebleeding. Conclusion Accurate medical history taking of anticoagulants may enable personnel to provide more effective management of these patients. The most important factors in the failure of primary care were not being able to find the precise area of bleeding and ineffective packing during the initial treatment. Therefore, it is important that we must carefully check the areas using the endoscope to decrease the failure of initial treatment of epistaxis.