A Clinical Study of 206 Hospitalized Patients with Epistaxis

Abstract

A clinical study of patients with epistaxis requiring hospitalization was conducted among 206 patients (male 141, female 65; mean age 62.6 years) admitted to Oita University Hospital from January 1996 to April 2017.

Occurrence was more common in winter and spring than in summer; 103 cases (50.0%) were after-hour visits. There were 137 cases (66.5%) with some underlying disease. The most common of which was hypertension in 96 patients (46.6%). Forty-two patients (20.4%) were taking anticoagulants.

Bleeding sites were unidentifiable in 58 cases (27.2%), followed by posterior nasal in 57 cases (26.8%), upper nasal in 28 cases (13.1%), the middle turbinate and middle meatus in 23 cases (10.8%), Kiesselbach’s area in 17 cases (8.0%), the inferior turbinate and meatus in 14 cases (6.6%), the nasal septum excluding Kiesselbach’s area in 14 cases (6.6%), and other nasal sites in 2 cases (0.9%); some cases had multiple bleeding sites.

Main treatments were gauze packing and electrocoagulation. Recently, there is an increasing tendency to perform electrocoagulation and sphenopalatine artery ligation while the frequency of Bellocq’s tamponade or balloon tamponade has decreased. This change in treatment regimen is considered to have facilitated precise observation and treatment using nasal endoscopy.

Re-bleeding after hospitalization occurred in 30 cases (14.6%), of which 17 cases (56.7%) had a misidentified or unidentified bleeding site at admission. Re-bleeding may be caused by misidentification of the bleeding site, so nasal endoscopy is important to perform hemostasis under clear vision of the bleeding sites.