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Serious spontaneous epistaxis and hypertension in hospitalized patients

  • Rhinology
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Abstract

The aim of the study was to evaluate the role of hypertension in patients hospitalized for serious spontaneous epistaxis. This 6-year retrospective study was based on 219 patients hospitalized in a University Hospital ENT and Head and Neck surgery department for serious spontaneous epistaxis. The following parameters were recorded: length of hospital stay, history of hypertension, blood pressure (BP) recordings (on admission, during hospitalization and on discharge), epistaxis severity criteria, including medical and/or surgical management of epistaxis (blood transfusion depending on blood count, embolization, surgery), medications affecting clotting. Epistaxis was classified into two groups: serious and severe. No significant differences were observed between the two groups in terms of age, sex ratio, history of epistaxis and BP characteristics including history of hypertension, mean BP on admission, mean arterial pressure on discharge and number of patients in whom BP was difficult to control. Patients with more severe epistaxis had a similar exposure to anticoagulant and platelet antiaggregant medications as patients with less severe epistaxis. Overall, on univariate logistic regression analysis, no factors were independently associated with severity of epistaxis. The pathophysiology of serious spontaneous epistaxis remains to be unclear. It concerns elderly patients (>60–70 years old) with a history of hypertension in about 50% of cases. Serious spontaneous epistaxis may also be the presenting sign of underlying true hypertension in about 43% of patients with no history of hypertension. However, hypertension per se does not appear to be a statistically significant causal factor and/or a factor of severity of serious spontaneous epistaxis.

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References

  1. Timsit CA, Bouchène K, Olfatpour B, Tsigaridis P, Herman P, Tran Ba Huy P (2001) Etude épidémiologique et clinique portant sur 20 563 patients accueillis à la grande garde d’urgence ORL adulte de Paris Ile de France (Epidemiology and clinical findings in 20, 563 patients attending the Lariboisière Hospital ENT Adult Emergency Clinic, French). Ann Otolaryngol Chir Cervicofac 118:215–224

    PubMed  CAS  Google Scholar 

  2. Klossek JM, Dufour X, de Montreuil CB, Fontanel JP, Peynègre R, Reyt E, Rugina M, Samardzic M, Serrano E, Stoll D, Chevillard C (2006) Epistaxis and its management: an observational pilot study carried out in 23 hospital centres in France. Rhinology 44:151–155

    PubMed  Google Scholar 

  3. Tan LK, Calhoun KH (1999) Epistaxis. Med Clin North Am 83:43–56

    Article  PubMed  CAS  Google Scholar 

  4. Kotecha B, Fowler S, Harkness P, Walmsley J, Brown P, Topham J (1996) Management of epistaxis: a national survey. Ann R Coll Surg Engl 78(5):444–446

    PubMed  CAS  Google Scholar 

  5. Viducich RA, Blanda MP, Gerson LW (1995) Posterior epistaxis: clinical features and acute complications. Ann Emerg Med 25:592–596

    Article  PubMed  CAS  Google Scholar 

  6. Pollice PA, Yoder MG (1997) Epistaxis: a retrospective review of hospitalized patients. Otolaryngol Head Neck Surg 117:49–53

    Article  PubMed  CAS  Google Scholar 

  7. Mitchell JR (1959) Nose-bleeding and high blood pressure. Br Med J 1:25–27

    Article  PubMed  CAS  Google Scholar 

  8. Charles R, Corrigan E (1977) Epistaxis and hypertension. Postgrad Med J 53:260–261

    Article  PubMed  CAS  Google Scholar 

  9. Isezuo SA, Segun-Busari S, Ezunu E, Yakubu A, Iseh K, Legbo J, Alabi BS, Dunmade AE, Ologe FE (2008) Relationship between epistaxis and hypertension: a study of patients seen in the emergency units of two tertiary health institutions in Nigeria. Niger J Clin Pract 11:379–382

    PubMed  CAS  Google Scholar 

  10. Fuchs FD, Moreira LB, Pires CP, Torres FS, Furtado MV, Moraes RS, Wiehe M, Fuchs SC, Lubianca Neto JF (2003) Absence of association between hypertension and epistaxis: a population-based study. Blood Press 12(3):145–148

    Article  PubMed  Google Scholar 

  11. Lubianca Neto JF, Fuchs FD, Facco SR, Gus M, Fasolo L, Mafessoni R, Gleissner AL (1999) Is epistaxis evidence of end-organ damage in patients with hypertension? Laryngoscope. 109:1111–1115

    Article  PubMed  CAS  Google Scholar 

  12. Lubianca-Neto JF, Bredemeier M, Carvalhal EF, Arruda CA, Estrella E, Pletsch A, Gus M, Lu L, Fuchs FD (1998) A study of the association between epistaxis and the severity of hypertension. Am J Rhinol 12:269–272

    Article  PubMed  CAS  Google Scholar 

  13. Herkner H, Laggner AN, Müllner M, Formanek M, Bur A, Gamper G, Woisetschläger C, Hirschl MM (2000) Hypertension in patients presenting with epistaxis. Ann Emerg Med 35:126–130

    Article  PubMed  CAS  Google Scholar 

  14. Herkner H, Havel C, Müllner M, Gamper G, Bur A, Temmel AF, Laggner AN, Hirschl MM (2002) Active epistaxis at ED presentation is associated with arterial hypertension. Am J Emerg Med 20:92–95

    Article  PubMed  Google Scholar 

  15. Knopfholz J, Lima-Junior E, Précoma-Neto D, Faria-Neto JR (2009) Association between epistaxis and hypertension: a one year follow-up after an index episode of nose bleeding in hypertensive patients. Int J Cardiol 134:e107–e109

    Article  PubMed  Google Scholar 

  16. Celik T, Iyisoy A, Yuksel UC, Karahatay S, Tan Y, Isik E. A new evidence of end-organ damage in the patients with arterial hypertension: epistaxis? Int J Cardiol 2009; doi:10.1016/j.ijcard.2008.11.090

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. ENT and Head and Neck Surgery Department, C.H.U Amiens, Centre Hospitalier Nord, Place Victor Pauchet, 80054, Amiens cedex, France

    Cyril Page, Aurélie Biet & Vladimir Strunski

  2. Clinical Pharmacology Department, CHU AMIENS - Hopital Sud, Avenue Laënnec, Salouel, 80054, Amiens cedex, France

    Sophie Liabeuf

  3. Nephrology Department, CHU AMIENS - Hopital Sud, Avenue Laënnec, Salouel, 80054, Amiens cedex, France

    Albert Fournier

Authors
  1. Cyril Page
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  2. Aurélie Biet
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  3. Sophie Liabeuf
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  4. Vladimir Strunski
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  5. Albert Fournier
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Correspondence to Cyril Page.

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Page, C., Biet, A., Liabeuf, S. et al. Serious spontaneous epistaxis and hypertension in hospitalized patients. Eur Arch Otorhinolaryngol 268, 1749–1753 (2011). https://doi.org/10.1007/s00405-011-1659-y

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  • DOI: https://doi.org/10.1007/s00405-011-1659-y

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