Investigation of the Frequency of Epistaxis and the Results of Anterior and Posterior Tamponade with and without Tuberculosis Surgery in Patients Referred to the Emergency Room of Kamkar-Arabnia Hospitals in Qom Province
Authors
- Saba Momeni - General Physician, Qom University of Medical Sciences, Qom, Iran.
-
Narges Alizadeh
- Assistant Professor of Otorhinolaryngology, Qom University of Medical Sciences, Qom, Iran.
https://orcid.org/0000-0002-9146-2600
DOI:
https://doi.org/10.22100/jkh.v19i1.3210Keywords:
Epistaxis, Tampon, Emergency, HospitalAbstract
Introduction: Epistaxis, also known as a nosebleed, is the bleeding from the nasal cavity or nasopharynx and is a common issue among individuals. Although epistaxis often resolves spontaneously, it can be life-threatening in certain cases, such as in elderly patients or those with underlying health conditions.
Methods: In this descriptive-analytical study, a convenience sampling method was used to evaluate 226 patients presenting with epistaxis at Kamkar and Arabnia Hospitals affiliated with Qom University of Medical Sciences. Data were collected using a checklist that included demographic information and interventions performed, and were analyzed in SPSS using descriptive and inferential statistics.
Results: A majority of patients diagnosed with epistaxis had local etiologies confined to the nasal area without systemic diseases, representing 51.8% (117 individuals). The study found significant correlations between pack-cell injection and Surgicel application (P<0.001), pack-cell injection and tampon type (anterior, anterior-posterior, or other treatments) (P=0.005), age and Surgicel application (P<0.001), age and tampon type (P<0.002), and age and referral reason (P<0.001). No significant relationship was observed between gender and tampon type (P=0.511).
Conclusion: Considering the significant correlations between the variables and the decrease in patient revisits for those treated with Surgicel, along with the potential use of pack-cell in critical cases, it is recommended to undertake essential actions to improve patient outcomes. The adoption of Surgicel for patient management is suggested for enhanced care.
References
Kodiya A, Labaran A, Musa E, Mohammed G, Ahmad B. Epistaxis in Kaduna, Nigeria: a review of 101 cases. Afr. Health Sci 2012;12:479-82. doi: 10.4314/ahs.v12i4.13
Mylonas S, Skoulakis C, Nikolaidis V, Hajiioannou J. Epistaxis Treatment Options: Literature Review. Indian J Otolaryngol Head Neck Surg 2023;8.1-10. doi: 10.1007/s12070-023-03824-z
Ikram T, Asim MU, Masood S, Fatima A, Akash H, Shahan Z, et al. Efficacy of chemical and electrical cautery (Comparison) in management of Anterior Epistaxis. J. Rawalpindi Med Coll 2022;1.6-10. doi: 10.37939/jrmc.v1i1.1807
Krulewitz NA, Fix ML. Epistaxis. Emergency Medicine Clinics 2019;37:29-39. doi: 10.1016/j.emc.2018.09.005
Iqbal H, Bukhari St, Hassan Tu. Frequency of hypertension in the patients presenting with epistaxis in ENT Department, Nishtar Hospital, Multan 2017;6.375-7
Tomkinson A, Roblin D, Flanagan P, Quine S, Backhouse S. Patterns of hospital attendance with epistaxis. Rhinology 1997;35:129-31.
Daniell HW. Estrogen prevention of recurrent epistaxis. Arch Otolaryngol Head Neck Surg 1995;121:354-361. doi: 10.1001/archotol.1995.01890030080017
Fishpool S, Tomkinson A. Patterns of hospital admission with epistaxis for 26,725 patients over an 18-year period in Wales, UK. The Annals of The Royal College of Surgeons of England 2012;94:559-62. doi: 10.1308/003588412X13373405386691
Nunez Da, Mcclymont Lg, Evans Ra. Epistaxis: a study of the relationship with weather. Clin Otolaryngol Allied Sci 1990;15:49-51.doi: 10.1111/j.1365-2273.1990.tb00432.x
Okafor B. Epistaxis: a clinical study of 540 cases. Ear Nose Throat J 1984;63:153-9
Juselius H. Epistaxis a clinical study of 1,724 patients. J Laryngol Otol 1974;88:317-27.
Pollice PA, Yoder MG. Epistaxis: a retrospective review of hospitalized patients. Otolaryngology—Head and Neck Surgery 1997;117:49-53. doi: 10.1016/S0194-59989770205-5
Venettacci O, Nettlefold C, Chan L, Daniel M, Curotta J. Sub-labial packing: a novel method of stopping epistaxis from Little's area. Int J Pediatr Otorhinolaryngol 2013;77:1370-1. doi: 10.1016/j.ijporl.2013.05.020
Bell G, editor Management of Epistaxis. Annual Refresher Course for the Family Physician;2016.
Morgan DJ, Kellerman R. Epistaxis: evaluation and treatment. Primary Care: Clinics in Office Practice. 2014;41:63-73. doi: 10.1016/j.pop.2013.10.007
Moran N DD. Epistaxis—Incidence, Etiology, and Management: A Hospital-based Study. Trauma 2016;16:57-97. doi: 10.5005/jp-journals-10013-1256
Walker TW MT, McGarry GW. The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995–2004. Clin Otolaryngol 2007;32:361-5. doi: 10.1111/j.1749-4486.2007.01530.x
Rahul RK AC, Sridevi K, Vinayakumar AR. Prevalence, risk factors and clinical presentations of patients with peripheral vertigo: a retrospective study from a tertiary care hospital. J Adv Med Med Res 2017;3:106-9. doi: 10.18203/2349-3933.ijam20160199
Alqarni ZM, Alajmi TA, Alhumaidi HH, AlharethAlhussain YMA, Alzahrani HSJA. Prevalence, causes, treatment, and outcome of epistaxis. 2019;60:30.
Monjas-Cánovas I, Hernández-García I, Mauri-Barberá J, Sanz-Romero B, Gras-Albert JR. Epidemiology of epistaxis admitted to a tertiary hospital. Acta Otorrinolaringologica (English Edition) 2010;61:41-7. doi: 10.1016/S2173-5735(10)70007-7
Knopfholz J, Lima-Junior E, Précoma-Neto D, Faria-Neto JR. Association between epistaxis and hypertension: a one year follow-up after an index episode of nose bleeding in hypertensive patients. Int J Cardiol 2009;134:e107-e9. doi: 10.1016/j.ijcard.2008.01.018
Kikidis D, Tsioufis K, Papanikolaou V, Zerva K, Hantzakos A. Is epistaxis associated with arterial hypertension? A systematic review of the literature. Eur Arch Otorhinolaryngol 2014;271:237-43. doi: 10.1007/s00405-013-2450-z
Terakura M, Fujisaki R, Suda T, Sagawa T, Sakamoto T. Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study. Am J Hypertens 2012;6:291-5. doi: 10.1016/j.jash.2012.05.001
Côrte FC, Orfao T, Dias CC, Moura CP, Santos M. Risk factors for the occurrence of epistaxis: Prospective study. Auris Nasus Larynx. 2018;45:471-5. doi: 10.1016/j.anl.2017.07.021
Danielides V, Kontogiannis N, Bartzokas A, Lolis C, Skevas A. The influence of meteorological factors on the frequency of epistaxis. Clin Otolaryngol Allied Sci 2002;27:84-8. doi: 10.1046/j.1365-2273.2002.00535.x
Lotfi A. Frequency of different causes of epistaxis in patients hospitalized in Imam Khomeini and Imam Reza hospitals during the last 10 years.
Haymes A, Harries V. ‘How to stop a nosebleed’: an assessment of the quality of epistaxis treatment advice on YouTube. J Laryngol Otol 2016;130:749-54. doi: 10.1017/S0022215116008410
Abootalebi Ghahnavieh A, Tashayoie A, Nasr Esfahani M, Golshani K. Comparative study of the efficacy of topical tranexamic acid with nasal tampon in management of epistaxis: A randomized clinical trial. Sci. J. Kurdistan Univ Med Sci 2020;25:140-9.
Reuben A, Appelboam A, Barton A, Vickery PJ, Body R, Hilton M, et al. Novel use of tranexamic acid to reduce the need for Nasal Packing in Epistaxis (NoPac) randomised controlled trial: research protocol. BMJ Open 2019;9:e026882. doi: 10.1136/bmjopen-2018-026882
Kasperek ZA, Pollock GF. Epistaxis: an overview. Emergency Medicine Clinics 2013;31:443-54. doi: 10.1016/j.emc.2013.01.008
Sajjadi M, Honarvar H, Basiri-Moghadam K, Nazemi H, Mirhaghi A. Comparison of merocel and regular tampon regarding comfort and problems of patients after septo-rhinoplasty surgery. Journal of Birjand University of Medical Sciences 2010;17:249-56.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
