A Clinical Study of Hospitalized Epistaxsis Patients

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  • Nario Kazuhiko
    Department of Otorhinolaryngology, Nara Medical University
  • Miyahara Hiroshi
    Department of Otorhinolaryngology, Head and Neck Surgery, Osaka General Medical Center
  • Sasai Hisanori
    Department of Otorhinolaryngology, Head and Neck Surgery, Osaka General Medical Center
  • Kamakura Aya
    Department of Otorhinolaryngology, Head and Neck Surgery, Osaka General Medical Center
  • Kajikawa Hiroshi
    Department of Otorhinolaryngology, Osaka Rosai Hospital
  • Matushiro Naoki
    Department of Otorhinolaryngology, Osaka Rosai Hospital

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  • 入院加療を要した鼻出血症例の検討

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Abstract

Based on the observation of 65 patients admitted for epistaxis from July 2000 to June 2007, we noted a higher frequency in men than women (male/female ratio about 2 to 1), a higher incidence among the middle-aged and olderly than in younger patients, and a higher epistaxis frequency in winter.<br>Among subjects, 25 (38.5%) had bleeding in Kisselbach's area, 13 (20%) in the inferior turbinate or meatus, 7 (10.8%) in the middle turbinate or meatus, 5 (7.7%) in the olfactory cleft, 1 (1.5%) in the bottom of the common nasal meatus, 1 (1.5%) in the posterior nasal septum, and 13 (20%) at unidentifiable sites. All were treated with gauze packing. Ten patients (15.4%) were treated with postnasal packing using Belloq's tampon or epistaxis balloon. None underwent surgical arterial ligation or arterial embolization.<br>Complications seen in 51 (78.5%) included hypertension, heart disease, liver disease, diabetic mellitus, postoperative heart disease (artificial valve replacement), and chronic renal failure. Anticoagulation therapy was conducted for 18 (27.7%) and wafarin therapy for 11 (16.9%). Epistaxis that complicates warfarin therapy is becoming increasingly common. Prothrombin time (international normalized ratio: INR) was measured routinely and ranged from 1.3 to 3.8, averaging 2.23. In all patients but one, warfarin was stopped temporarily until epistaxis was controlled. No thromboembolic complications occurred.<br>When epistaxis is encountered in the elderly, it thus becomes to consider both local treatment for epistaxis and the possibility of systemic disease.

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