Epistaxis health disparities in the United States pediatric population

Yang, Lindsay; Hur, Kevin; Koempel, Jeffrey A.; Ference, Elisabeth H.

doi:10.1016/j.ijporl.2018.08.025

Cited by 18 publications

(15 citation statements)

References 19 publications

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“…Meanwhile, the 4 months are exactly the months with the highest pollen concentration in Beijing, 12,13 the onset of allergic rhinitis increases correspondingly, 14 suggesting that allergic rhinitis may be correlated with nasal bleeding to some extent. This is consistent with a recent American study 15 about epistaxis in pediatric population. Clinically, we also found that children with allergic rhinitis often blow their nose due to lots of clear watery secretion or rub and dig their noses fiercely due to severe nasal itching.…”

Section: Discussionsupporting

confidence: 93%

Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017

Liang

et al. 2019

Ear Nose Throat J

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Background: Epistaxis is a common symptom in children. The effect of air pollution on epistaxis is not yet clear. Objectives: To explore the characteristics of pediatric epistaxis in Beijing and its correlation with air pollutants. Material and Methods: Data were collected from 2014 to 2017 in Otolaryngology Department of Capital Institute of Pediatrics. Children diagnosed with epistaxis with relevant information with the same period of municipal air pollutants’ concentration were compared. Results: The annual visits of epistaxis showed a bimodal trend. The incidence of epistaxis in infants was low, increased with age, reached the peak between the ages of 4 to 5, and then gradually decreased with age. In different age groups, male patients were more than females. From 2014 to 2017 in Beijing, particulate matter less than 2.5 μm in diameter (PM2.5), particulate matter less than 10 μm in diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) showed a downtrend, lower in summer than in the other 3 seasons. Ozone (O3) was significantly higher in 2016 and 2017, showed an increase trend in summer. The incidence of epistaxis was negatively correlated with PM2.5, PM10, SO2, NO2 and CO, which was positively correlated with O3 ( P < .05). Conclusions: Pediatric epistaxis in Beijing changes with age and has obvious seasonal variation. There are some correlations between air pollutants and the incidence of epistaxis in children.

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Section: Discussionsupporting

confidence: 93%

Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017

Liang

et al. 2019

Ear Nose Throat J

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“…Several studies have proven that allergic rhinitis is closely associated with epistaxis ( 19 , 20 ). Other sinonasal diseases could also influence the occurrence of epistaxis.…”

Section: Discussionmentioning

confidence: 99%

Age-specific associations between environmental factors and epistaxis

Ahn

Min²

2022

Front. Public Health

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ObjectiveSeveral studies have demonstrated that environmental factors, such as meteorological factors and air pollutants, are closely associated with epistaxis. However, age-specific associations between environmental factors and epistaxis have not yet been evaluated. This study aimed to evaluate the associations between individual meteorological factors and air pollutants and epistaxis, by age.Study designA retrospective cohort study.SettingRecords of patients covered by the Korean National Health Insurance Service who visited our hospital for epistaxis between January 1, 2002, and December 31, 2015, were retrospectively reviewed.MethodsThe 46,628 enrolled patients were divided into four age groups: age group 0 (<18 years, N = 19,580); age group 1 (18–40 years, N = 10,978); age group 2 (41–70 years, N = 13,395); and age group 3 (>70 years, N = 2,675). Cases of epistaxis and data on environmental factors were analyzed according to the day, month, and year. Stepwise logistic regression was performed to identify the environmental risk factors for epistaxis in each age group.ResultsAge group 0 had the highest number of patients with epistaxis, whereas age group 3 had the lowest. Relative humidity, temperature, concentrations of particulate matter (PM10) and sulfur dioxide, sunshine duration, and wind speed were significantly associated with the occurrence of epistaxis in the study population. However, analysis according to age group showed that the meteorological factors and air pollutants associated with epistaxis were different in each age group.ConclusionWe suggest that the environmental risk factors for epistaxis should be differentially analyzed according to age.

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“…The few prior studies that have examined the relationship between epistaxis and race have had mixed results. One study that examined a national database of outpatient pediatric epistaxis encounters found that Black children were more likely to present with epistaxis (95% CI: 1.3, 4.1, p=0.005) compared with White children 12. A second study of 4120 patients presenting to the emergency departments with epistaxis found that those who identified as Black were more likely to present with epistaxis when compared with non-Hispanic White patients 13.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of patient race on clinical outcomes or quality of life have been established in many disorders, including chronic kidney disease, sickle cell disease, and diabetes 9–11. Few studies with mixed results have examined disparities with regards to epistaxis on a population level, and no studies have previously specifically examined disparities in patients with HHT 12–15. Environmental justice in particular recognizes how factors such as air pollution can negatively affect marginalized populations, who often suffer from higher concentrations of air pollution in addition to social risk factors 16.…”

Section: Introductionmentioning

confidence: 99%

Identifying racial disparities in hereditary hemorrhagic telangiectasia

Yusuf

Rasheed

Kim

et al. 2022

J NeuroIntervent Surg

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BackgroundHereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by recurrent epistaxis (nose bleeds), mucosal telangiectasias (spider veins), and arteriovenous malformations. Although HHT affects all racial groups, few studies have explored racial disparities among patients with HHT.MethodsWe performed a retrospective chart review of HHT patients who were seen at a single academic center between July 1, 2014 and January 1, 2022. The primary outcomes of this study were the Epistaxis Severity Score (ESS) and the presence of pulmonary, cerebral, gastrointestinal, spinal, and hepatic arteriovenous malformations (AVMs). We analyzed racial differences using t-tests and analysis of variance (ANOVA) for continuous variables, and chi-squared tests for categorical variables. We then performed multivariable linear and logistic regressions on outcomes.ResultsOur review identified 35 Asian, 6 Black or African American, 72 Hispanic or Latino, and 244 White or Caucasian patients who met the inclusion criteria. Through an analysis of variance model, race/ethnicity was not significantly associated with ESS. Two univariable logistic regression models between race and both pulmonary and brain AVMs showed that race was associated with the incidence of pulmonary AVMs (p<0.01), with Asian patients at a 2.3-fold increased risk of pulmonary AVMs compared with White patients (p=0.03). Race was also associated with the incidence of cerebral AVMs (p<0.01) with Hispanic or Latino patients at a 4.8-fold increased risk compared with White patients (p<0.01).ConclusionPatients who identified as Asian may have higher rates of pulmonary AVMs while patients identifying as Hispanic or Latino may have more cerebral AVMs. The correlations may be important for identifying risk factors in certain patient populations.

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Epistaxis health disparities in the United States pediatric population

Cited by 18 publications

References 19 publications

Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017

Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017

Age-specific associations between environmental factors and epistaxis

Identifying racial disparities in hereditary hemorrhagic telangiectasia

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