Epistaxis: The demographics, etiology, management, and predictors of outcome in Jos, North-Central Nigeria

Abstract

Background: Epistaxis, though a mere nuisance can have life-threatening consequences. This first study from Jos on epistaxis aims to determine its sociodemographic characteristics, causes, the treatment modalities and the predictors of patient outcome. Study Design: A retrospective chart review. Methods: Health records of patients that met the inclusion criteria for epistaxis at the Jos University Teaching Hospital, Jos, Nigeria, between February 2011 and December 2015 were retrieved manually using standardized codes in the International Classification of Diseases 10 th revision and studied for age, gender, associated comorbidities, treatment modalities offered, and outcome of treatment. Results: We managed 154 patients. Records of 92 patients were retrievable aged between 1 and 85 years (Mean = 37.7; standard deviation ± 16.2) with male to female ratio of 2.3:1. Patients in the third decade were the largest group. The most common cause was idiopathic. Anterior nasal bleeding occurred in 51.1%, posterior nasal bleeding in 34.8%. Conservative management was effective in 84.8%. Etiological factors other than chronic liver disease and otolaryngological malignancies showed statistically significant association with good patient outcomes ( P = 0.013, P = 0.044, and P = 0.026, respectively). A mortality rate of 5.4% was recorded. Conclusion: Epistaxis of idiopathic origin occurring mostly in young males is the most common with most resolving on conservative management. Early hospital presentation, normal blood pressure at presentation and all management modalities were positive predictors of outcome in our patients.

Epistaxis in the University of Port Harcourt Teaching Hospital: Aetiological Profile and Management

“…The current study found females to be more affected than males among the study population of 196. This is in contrast with most other studies where the incidence is higher in males [10,20,21]. The male preponderance was attributed to the males being more robust and engaging more in conditions that could predispose to epistaxis, however, this was not the case in the present study.…”

“…The age group of 30-39 was the most affected followed by age 20-29 years. This was similar to the findings of some other studies in Nigeria; Akinpelu et al and Eziyi et al had 21-40 years as the commonest age affected while Adoga et al also had the 3 rd decade mostly affected in their study [23,24,21]. Also, Gilyoma&Chalya in Northwestern Tanzania, had 31-40 years [25] as the group affected most.…”

“…In majority of the patients studied, the cause of the nasal bleed could not be ascertained, 58.2%. This was also noted by other researchers [21,26]. A study in Indiaalso could not find the cause in about 38.09% [22].…”

“…It was also noted as a common cause in some other works; An earlier work in southwestern Nigeria showed trauma to be the highest cause in 70.9% of their cases. While it ranked the second commonest cause of epistaxis in some other studies [21,27,28]. The type of trauma however differed in the different studies, the present study recorded nose picking while Akinpelu had maxillofacial injuries secondary to RTA as the commonest type of trauma [23].…”

“…Malignancies of the nose and nasopharynx were all implicated in the aetiology of epistaxis but in the present study it represents only 3.1% of the cases. In most of these works, therefore, idiopathic, trauma and hypertension appear to be commonly associated factors with epistaxis [10,21,25,27,31].…”