[Risk factors and clinical variables in patients hospitalized for epistaxis. Review of 200 patients]. / Factores de riesgo y variables clínicas en pacientes hospitalizados por epistaxis. Revisión de 200 pacientes.

It is reported a review of 200 adult patients admitted for epistaxis in our Hospital during a 10 years period (1992-2002). This study evaluates several factors included in the clinical histories: HTA, infection of the upper airway, EPOC, cardiovascular pathology, use of anticoagulant medication or other drugs, tobacco, alcohol, diabetes, etc. Besides we collected variables like age, sex, bleeding location, type of nasal packing made and evolution. Less than 20% of the cases were classified as idiopatic and the hospitalized patients had one or more known risk factors.

Epistaxis in healthy children requiring hospital admission.

OBJECTIVES: To determine the outcomes for healthy children who require admission to hospital with acute epistaxis. METHODS: A 10-year retrospective review of admissions with acute epistaxis under the Otolaryngology Department in a tertiary pediatric centre was performed. RESULTS: There were 14 cases (11 males, 3 females), with mean age 7.8 years (1.9-18.3 years). Three patients had a history of recent aspirin ingestion, and one had sustained nasal trauma. Mean hemoglobin at presentation was 105g/L (75-150), and no patient was diagnosed with a bleeding disorder. Four patients underwent surgical intervention, and one patient received a blood transfusion or blood product. The mean length of hospital stay was 3.6 days (2-14 days). CONCLUSIONS: Acute epistaxis in healthy children that requires hospital admission is generally not a marker for an underlying bleeding disorder. It is associated with a short inpatient stay, and usually requires minimal intervention.

[Epidemiological notes on nasal bleeding]. / Notas epidemiológicas sobre el sangrado nasal.

The incidence of epistaxis is difficult to calculate because only a 10% of them look for medical attention. In this study the nasal bleeding means the 13.3% of the ENT emergencies (279 patients). Its incidence was 6 cases/10,000/year. The majority were over 50 years old (57.3%). There was season variations. The anterior epistaxis were more frequent but he posterior ones increased over the 40. An 18% had rebleeding more significatively with age and localization. We discuss the mechanisms that can explain the male dominance, the season incidence, and the old ages of the patients with hospital epistaxis.

[Epidemiological analysis of patients cure in frame of emergency in ORL clinic in Warsaw, stepiniska 15/21 in 1996]. / Analiza epidemiologiczna pacjentów zaopatrywanych w ramach "ostrych" dyzurów laryngologicznych w klinice ORL w warszawie ul. stepinska 15/21 w 1996 r.

Study the epidemiological and clinical features of patients attending the emergency in the Clinic during 12 months to think whether the emergency is still needed as a one of method of curing. 4892 patients attended the emergency. Parameters analyzed were: age, sex, hour and day of arrival, place of living, initial signs, hospitalization and surgical services. The most frequent reasons for coming to the emergency were: ear disease (32.2%--middle ear otitis), nose disease (662 patients), bleeding nose (559 patients). The most frequent reason for hospitalization were swallowed foreign body (16.5%), tumor of the larynx and pharynx (16%), vestibulary nerve (12.9%). Emergency is an important sector of hospital activity, with a mean 55 per day (week-days), 87 per day (week-end and out of job days). The majority men disease were facial traumas, women were disease of vestibulary nerve, sudden hearing loss. However, 33% of the consultation in the emergency apper to be real medical emergencies, others could be appropriately provided by a general practitioner.

Aspirin, nonsteroidal anti-inflammatory drugs, and epistaxis. A regional record linkage case control study.

To assess the relationship between nonsteroidal anti-inflammatory drugs (NSAIDs) and spontaneous epistaxis in adults over 50 years old, a case control study was carried out by using a record linkage database for the population of Tayside, Scotland, which included 319,465 people. The study group consisted of 326 patients who were hospitalized with epistaxis between May 1989 and December 1992, but who had not previously been hospitalized with this diagnosis. Six community controls and 4 hospital controls, matched for age and sex to each case, were used. Previous exposure to prescribed aspirin and other NSAIDs was investigated. There was a significant association between aspirin exposure and epistaxis when either community or hospital controls were used (p < .001). Patients who had aspirin prescriptions had a relative risk of hospital admission for epistaxis of between 2.17 and 2.75, depending on the control group used. No association between non-aspirin NSAIDs and epistaxis was evident with either control group.

[A study of the incidence and hospital follow-up of epistaxis in patients treated with anticoagulant acenocoumarol]. / Estudio sobre la incidencia y seguimiento hospitalario de epistaxis en pacientes anticoagulados con acenocumarol.

Nosebleed is a common reason for emergency ENT consultations, but it is infrequent in patients anticoagulated with acenocoumarol. In a retrospective 5-year study, nosebleed was the second most frequent type of hemorrhage among anticoagulated patients. Such patients do not necessarily have prolonged coagulation times. In a comparison of patients hospitalized for nosebleed (n = 14) with a similar group with no hemostasis abnormalities, patients with nosebleed had longer hospital stays and required more control measures. The greater the tendency to hypocoagulation, the more difficult it was to manage nosebleed. Recent onset of anticoagulation therapy and previous long coagulation times favored the appearance of hard-to-manage nosebleed. Therefore, hematologists should closely control patients under anticoagulation therapy and cooperate with the ENT department when such patients are admitted for nosebleed.

Posterior epistaxis: our experience with transantral ligation and embolisation.

Transantral ligation of the arteria maxillares internae (AMI) (with or without ligation of the arteria ethmoidalis) and percutaneous embolisation of AMI in cases of intractable epistaxis (i.e. epistaxis not responding to classical posterior packing) are compared. Except when ethmoidal bleeding is suspected, we recommend embolisation for epistaxis not responding to classical measures as it leads to fewer complications and recurrences, to shorter hospital stay and to improved postoperative comfort.

[Device for controlling hemorrhage in the nasal cavity]. / Przyrzad do tamowania krwotoków z jamy nosowej.

Authors describe a controlling device in a nasal haemorrhage which has been accepted as the registered model No: PL 52469-Y1. The presented device has been applied in many cases of nasal haemorrhage in patients in First Department of Laryngology of the Silesian University School of Medicine in Katowice.

Hospital epistaxis admission rate and ambient temperature.

The incidence of epistaxis admissions to hospital and their relationship to ambient temperature is examined. A retrospective analysis of 1211 patients with epistaxis sufficiently severe to warrant hospital admission was performed over a period of 1836 consecutive days. Daily average temperature data for this time-period were examined and compared with admission rates. A marked increase in hospital attendance was apparent during colder days. Patients were admitted at a rate of 0.829 patients per day for temperatures less than 5 degrees C, (95% Confidence Interval: 0.737-0.928), compared with 0.645 patients per day for temperatures between 5.1 and 10 degrees C, (95% 0.586-0.708). On average the population of epistaxis patients attended on days that were 0.6 degree C colder (95% Confidence Interval: 0.2 degree C-0.9 degree C) than the average temperature for the time examined (P < 0.005, student's t-test).