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Descriptive epidemiology of epistaxis in a tertiary care hospital

Melootu Thomas Anie, Gopinatha Menon Arjun, Chakramakal Joseph Andrews, Arayamparambil Rajagopalan Vinayakumar.

Abstract
Background: Epistaxis is recognized as one of the most common otorhinolaryngological emergencies affecting the population worldwide. This study is aimed to find out the common etiological factors and the most common treatment modality in the management of epistaxis in our population.
Methods: A cross sectional study on 110 patients of age 4 to 82 years was done. A detailed history, physical examination and laboratory assessment to rule out the various causes of epistaxis had been done. Details of management of epistaxis in each patient were taken and the data was analysed statistically.
Results: There were 78 males (70.9%) and 32 females (29.1%) with a male to female ratio of 2.4. Epistaxis was found to be more prevalent in the elderly, above 60 years age (n=25). No significant gender difference observed in the geriatric age group. The commonest cause of epistaxis was trauma (56.4%) followed by hypertension (11.8%) and infection of sinuses (10.9%). Hypertension (p =0.0001), CAD (p= 0.013) and CKD (p= 0.044) were found to have significant association. Non surgical measures were the main intervention. Among the nonsurgical management, only medical management was needed in 69 cases (62.7%). Most common surgical intervention was open reduction and internal fixation of facial bones in maxillofacial injuries.
Conclusions: Commonest cause of epistaxis was trauma followed by hypertension and infection of sinuses. Systemic factors are the major underlying cause of epistaxis in above 60 year age group. Reducing the incidence of trauma from road transport cases will reduce the incidence of emergency epistaxis.

Key words: Epistaxis, Trauma, Hypertension, Malignant neoplasm, Etiology, Antiplatelets



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