[Clinical management of epistaxis]

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.