Epistaxis: Are temperature and seasonal variations true factors in incidence?

Bray, Dominic; Giddings, Charles; Monnery, P.M.; Eze, N. C.; Lo, Shih Hsuan; Toma, A.

doi:10.1258/0022215054798032

Cited by 54 publications

(63 citation statements)

References 4 publications

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“…Although it can be suggested that epistaxis occurs more frequently in the dry and cold months, some studies question this paradigm. 21,22 Our numbers show a clear cumulation of cases in winter and spring, with a significant difference from European summer months. This is most probably caused by dry air conditions in the colder months.…”

Section: Discussionmentioning

confidence: 65%

Is severe epistaxis associated with acetylsalicylic acid intake?

et al. 2009

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Objectives/Hypothesis: Epistaxis represents a very common emergency in any ear, nose, and throat (ENT) department around the world. Despite other risk factors, acetylsalicylic acid (ASA) contributes to nosebleeds by its intrinsic ability to impair thrombocyte aggregation. The aim of this study was to investigate the influence of ASA on the severity of epistaxis and to compare it with other potential risk factors.Study Design: A prospective cohort study was performed at the ENT department of University Hospital Zurich.Methods: A total of 591 events were evaluated concerning surgical interventions and the length of in-hospital stay. Further analyses regarding recurrences and number of treatments and a specially designed severity score, as well as other outcome parameters, were performed.Results: Ninety-nine patients needed to stay inhospital for at least 1 day. Nearly 30% of all patients had ASA intake, and only 18% were on vitamin K antagonist therapy. Patients on ASA showed significantly more surgical interventions, a higher recurrence rate, and a larger number of required treatments as well as an increased severity score. Duration of in-hospital stay and the complication rate, however, were not associated with drug intake.Conclusions: We not only identified ASA to be one of the major risk factors in epistaxis, but also quantified its impact on the severity of nose bleeding. We emphasize the importance of a well-indicated antiaggregational therapy, and strongly discourage using ASA as a life-style drug for the elderly. ASA therapy needs to be discontinued whenever possible and reasonable.

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Section: Discussionmentioning

confidence: 65%

Is severe epistaxis associated with acetylsalicylic acid intake?

et al. 2009

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“…Similarly, in this study we found a significant association between age and readmissions; with higher rates in patients 76 years and older. The elderly may be susceptible to initial episodes of epistaxis due to diminished elasticity of their nasal vessels [13]. However, an association between age and recurrent epistaxis requiring an ED readmission has not been previously reported [11,12].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing recurrent emergency department visits for epistaxis in the elderly

Chaaban¹,

Zhang

Resto

et al. 2018

Auris Nasus Larynx

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Objective Our objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly. Methods We used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months. We assessed the rates of ED visits for recurrent epistaxis in the 12 months following the incident visit. Our variables included demographics, geographic location, procedures performed during the incident visit and comorbidities. Results Out of the 4120 patients with incident epistaxis, 775 were readmitted with recurrent epistaxis within 12 months. 60% presented in the first 30 days and 75% within 90 days. There was a significant increase in ED visits for patients over 75 years of age and in men compared to women. Recurrent ED visits for epistaxis was higher in patients with congestive heart failure, diabetes mellitus, and obstructive sleep apnea compared to those without these comorbidities. Conclusion Additional ED visits for epistaxis are more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.

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“…Several studies have examined the relationship between season, temperature, humidity and the presentation of epistaxis. The majority of these studies have shown a correlation with case frequency and at least one of the above-mentioned meteorological factors, [1-8] but other studies have shown no relationship [9-11]. Despite numerous reports on this topic, no known studies have been performed in a location with temperature fluctuations as great as in Alberta, Canada.…”

Section: Introductionmentioning

confidence: 99%

Role of season, temperature and humidity on the incidence of epistaxis in Alberta, Canada

Sowerby

DeSerres

Rudmik

et al. 2014

J of Otolaryngol - Head & Neck Surg

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BackgroundClassical dogma holds that epistaxis is more common in winter months but there is significant variability reported in the literature. No study has yet examined the effect of season, humidity and temperature on epistaxis in a location with as severe weather extremes as seen in Alberta, Canada. The objective of the study is to evaluate for an effect of these meteorological factors on the incidence of epistaxis in Alberta.MethodA retrospective review of consecutive adult patients presenting to the Emergency room (ER) in Edmonton and Calgary, Alberta over a three-year period was performed. Daily temperature and humidity data was recorded from the respective airports. Statistical analysis with Pearson’s correlation coefficient was performed.Results4315 patients presented during the study period. Mean daily temperatures ranged from a low of -40°C to a high of +23°C. A significant negative correlation was found for mean monthly temperature with epistaxis (Pearson’s r = -0.835, p = 0.001). A significant correlation was also present for daily temperature and epistaxis presentation (Pearson’s r = -0.55, p = 0.018, range 1.8 to 2.2 events/day). No correlation was identified with humidity and no significant seasonal variation was present.ConclusionsA negative correlation was found to exist for both daily and mean monthly temperature with rates of epistaxis. A seasonal variation was seen in Edmonton but not in Calgary. No correlation was found for humidity when compared to both presentation rates and admissions.

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Epistaxis: Are temperature and seasonal variations true factors in incidence?

Cited by 54 publications

References 4 publications

Is severe epistaxis associated with acetylsalicylic acid intake?

Is severe epistaxis associated with acetylsalicylic acid intake?

Factors influencing recurrent emergency department visits for epistaxis in the elderly

Role of season, temperature and humidity on the incidence of epistaxis in Alberta, Canada

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