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Related Concept Videos

Epistaxis01:30

Epistaxis

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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
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Clinical Manifestations:
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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
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[Clinical management of epistaxis].

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Summary

Older patients with posterior epistaxis and multiple health issues, especially those on blood thinners, often require hospitalization. Nasal packing is usually effective, but lab tests are key for coumarin users to monitor international normalized ratio (INR).

Keywords:
CoumarinsEpistaxisMultimorbidityRelapsesTherapy

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Area of Science:

  • Otolaryngology
  • Internal Medicine
  • Emergency Medicine

Background:

  • Epistaxis (nosebleeds) are common in acute medicine, stemming from diverse and often multifactorial causes.
  • Understanding epistaxis etiology and management is crucial for effective patient care.

Purpose of the Study:

  • To analyze diagnostic and therapeutic approaches for epistaxis.
  • To evaluate complications and the predictive value of laboratory tests in epistaxis management.

Main Methods:

  • Retrospective clinical analysis of 720 patients with epistaxis from January 2005 to December 2015.
  • Evaluation of epistaxis causes, relapse management, and associated factors.

Main Results:

  • Male patients predominated; older patients (>70 years) with higher multimorbidity and on blood thinners experienced more epistaxis relapses.
  • Posterior bleeding sites were most common, leading to longer hospitalizations. Nasal tamponade was the primary treatment.
  • Anemia requiring transfusion was the most frequent complication. Inadequate international normalized ratio (INR) control was noted in patients using coumarins. Nicotine consumption was elevated.

Conclusions:

  • Advanced age and posterior bleeding necessitate inpatient care for epistaxis.
  • Nasal tamponade is generally sufficient for treatment, but initial lab tests have limited predictive value for recurrence risk.
  • Laboratory testing is essential for patients on coumarins to ensure adequate INR control.