Epistaxis - Etiological Profile and Treatment Outcome at a Tertiary Care Centre

Abstract

BACKGROUND:Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at SKIMS Medical College, Bemina, Srinagar, a tertiary care hospital. METHODS: This was a prospective descriptive study of the cases of epistaxis managed at SKIMS Medical College, Bemina, Srinagar, a tertiary care hospital, from July 2014 to January 2015.All patients of acute epistaxis due to any cause were included. The data for the following variables was collected; gender, age, age group, cause, type and laterality of epistaxis and success rate of treatment modalities. RESULTS: A total of 114 patients with epistaxis were studied. Males were affected more than the females (1.8:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The commonest cause of epistaxis was trauma (46.22%) followed by hypertension (25.43%) and idiopathic (18.43%). Anterior nasal bleeding was noted in majority of the patients (69.29%). Non-surgical measures were the main intervention methods in 99.12% of cases and of this, local cauterization (49.12%) and anterior nasal packing (26.31%) were most common non-surgical measures. Surgical measures mainly tumor resection was carried out in 0.87% of cases. The overall success rate of treatment was 92.0%. CONCLUSION: Epistaxis is the commonest otolaryngological emergency. Trauma resulting from road traffic accident (RTA) remains the most common etiological factor for epistaxis. Most cases can be successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTA will reduce the incidence of emergency epistaxis.

Epistaxis: Etiological Profile and Treatment Outcome in a Teaching Hospital of North Eastern State of Sikkim, India

“…The management protocol of our study was as per the standard protocol (p=0.002). In a study conducted by Shah WA et al (4) on 114 patients, non-surgical methods were main intervention method in 99% of the cases, the results of which is similar to our study.…”

“…Traumatic epistaxis is most common in younger individuals and is most often due to digital trauma, facial injury or a foreign body in the nasal cavity. (4) Non traumatic epistaxis is more characteristic of older patients (Over age 50 years) and may be due to organ failure, neoplastic conditions, inflammation or environmental factors (Temperature, humidity, altitude). (4) Epistaxis occurring in younger individuals are usually mild and originates in anterior nose, whereas epistaxis of elderly is more likely to be severe and originate posteriorly.…”

“…(4) Non traumatic epistaxis is more characteristic of older patients (Over age 50 years) and may be due to organ failure, neoplastic conditions, inflammation or environmental factors (Temperature, humidity, altitude). (4) Epistaxis occurring in younger individuals are usually mild and originates in anterior nose, whereas epistaxis of elderly is more likely to be severe and originate posteriorly. (4,5) The treatment of epistaxis requires a systematic and methodological approach and option varies according to cause, location and severity of the haemorrhage.…”

“…(4) Epistaxis occurring in younger individuals are usually mild and originates in anterior nose, whereas epistaxis of elderly is more likely to be severe and originate posteriorly. (4,5) The treatment of epistaxis requires a systematic and methodological approach and option varies according to cause, location and severity of the haemorrhage. Both conservative and surgical approach has been used as the treatment modalities for epistaxis.…”

“…Both conservative and surgical approach has been used as the treatment modalities for epistaxis. (4) Though there are large number of literatures on epistaxis from across the world and India but there are very few studies from the north eastern part of the country. Our study is unique as it is being carried out in population who lives in high altitude with tough climatic condition and may help us compute some unknown aetiology of epistaxis.…”