Determining the Effect of Seasonality on Pediatric Epistaxis

Determine if there is an association between season and epistaxis.

Retrospective analysis of the season in which patients aged 1- to 17 years old were referred to otolaryngology for epistaxis within a single health system located in mid-atlantic region from January 01, 2010 to December 31, 2020. Exclusion criteria were diagnosis of nasal trauma within 1 month of referral, bleeding disorder, or use of anticoagulation medication. The distribution of patients referred with epistaxis among the four seasons was compared with all pediatric otolaryngology referrals using chi-squared analysis with adjusted residual testing.

31,866 pediatric patients were referred to otolaryngology over the study period. The distribution of total pediatric otolaryngology referrals that were for epistaxis was: 557 referrals in fall, 568 in winter, 669 in spring, and 534 in summer. Chi-squared with 3 df was 16.4 (p = 0.001). There was no significant difference between the proportions of total referrals that were for epistaxis when comparing by season. Treatment modalities were analyzed across seasons among the 912 patients who went to their referred visit; no significant difference was found when looking at cautery, nasal mucosal hydration, both modalities, or neither across seasons. Analysis of follow-up visits revealed no significant difference between seasons.

Epistaxis referrals, observed visits, follow-up visits, nasal cautery, and nasal mucosal hydration were not significantly different in winter compared with other seasons. We present data incongruent with conventional teaching that epistaxis is most common in dry, winter weather. These results suggest modifying patient counseling on epistaxis treatment year-round.

3, case-control study.