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Risk factors associated with epistaxis in children

Melissa Cummins1, Connor Hunt2, Hassan H Ramadan3

  • 1West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA.

International Journal of Pediatric Otorhinolaryngology
|June 17, 2025
PubMed

Insights

Pediatric epistaxis (nosebleeds) is more common in winter. Intranasal corticosteroid spray (INCS) use may reduce the risk of nosebleeds in children, while age, gender, and septal deviation are not significant factors.

Area of Science:

  • Pediatrics
  • Otolaryngology
  • Environmental Health

Background:

  • Epistaxis, or nosebleeds, is a common pediatric concern.
  • Previous research suggests a link between epistaxis and environmental factors like climate change and temperature fluctuations.
  • Understanding pediatric epistaxis risk factors is crucial for prevention and management.

Purpose of the Study:

  • To investigate the association between environmental factors and pediatric epistaxis.
  • To identify specific risk factors contributing to nosebleeds in children.
  • To evaluate the role of intranasal corticosteroid spray (INCS) use in pediatric epistaxis.

Main Methods:

  • A retrospective case-control study was conducted involving pediatric patients from August 2020 to February 2024.
  • Cases were children presenting with epistaxis; controls were children with other rhinologic conditions.
  • Exclusion criteria included chronic rhinosinusitis, bleeding disorders, and use of antiplatelets or anticoagulants.

Main Results:

  • The study included 332 children (98 epistaxis cases, 234 controls).
  • Epistaxis cases were more frequent during winter months (p=0.013).
  • Reduced risk of epistaxis was associated with INCS use (OR=0.19, 95% CI=0.06-0.66), while winter seasonality increased risk (OR=1.79, 95% CI=1.07-2.99).

Conclusions:

  • Pediatric epistaxis is significantly associated with colder seasons.
  • Intranasal corticosteroid spray (INCS) use appears to be a protective factor against pediatric epistaxis.
  • Allergic rhinitis, nasal septal deviation, age, and gender were not found to be significant risk factors.
Abstract

Keywords:
EpistaxisIntranasal steroid usePediatricRisk factorsSeasonality

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