Analysis of etiology and treatment methods of epistaxis in adult patients visiting
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Introduction: Epistaxis is not only the most commonly seen type of bleeding in laryngological emergency department, but also a frequent reason of visiting this department. It may be a symptom of trivial disorder or serious systemic either chronic disease.Aim of study: The primary objective of this study was to analyze the etiology and treatment methods of epistaxis in adult patients. Material and methods: This was the retrospective study of 574 adult patients who visited the Emergency Department of Otolaryngology in Public Central Teaching Hospital between 1st January and 30th December 2014 because of epistaxis. There were 274 females and 300 males with the mean age of 64,6 years (woman), and 60,3 years (men). Results: 228 patients (39,7%) were chronically treated for hypertension. Blood pressure measurement was performed in 335 patients (58,4%) and elevation over 160 mmHg systolic, or over 95mmHg diastolic took place in 132 cases (22,99%). Other significant factor observed in the study was anticoagulant and antithrombotic drug usage. In 134 cases (22,3%) patients were treated with medicine from this group (the most frequently- acetylsalicylic acid). Other accompanying disorders were: heart failure, atrial fibrillation, diabetes mellitus, other cardio-/cerebro-vascular diseases, COPD, respiratory track infection. The most common intervention in case of epistaxis was nasal packing (Rapid Rhino – 248 patients, Spongostan sponge – 129 patients). Captoprilum was administered in 79 cases (13,8%) to normalize elevated blood pressure. 90 patients (15,6%) required an additional internal medicine consultation. Conclusion: The impaired control of hypertension and treatment with oral anticoagulant (acenocumarol) or antithrombotic drugs (acetylsalicylic acid) were the most common reasons of epistaxis in examined group of patients. The most frequent symptomatic management were packing with Spongostan sponge and Rapid Rhino balloon tampon. Typical anterior nasal tamponade with gauze was much less frequent. The treatment according to the etiology was added if needed.
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