Cohen Oded, Shoffel-Havakuk Hagit, Warman Meir, Tzelnick Sharon, Haimovich Yaara, Kohlberg Gavriel D, Halperin Doron, Lahav Yonatan
1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
2 Hadassah Medical School, Hebrew University, Jerusalem, Israel.
Otolaryngol Head Neck Surg. 2017 Sep;157(3):424-431. doi: 10.1177/0194599817705619. Epub 2017 May 2.
Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs. Results A total of 653 patients were included. Eighty-six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs. Conclusion Early and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.
目的 鼻出血是一种常见症状，但很少有研究关注复发性鼻出血的发生率及危险因素。我们的目的是确定复发性鼻出血入院（REA）的发生率模式及危险因素。研究设计 病例系列研究并进行图表回顾。研究地点 单一学术中心。研究对象与方法 回顾了1999年至2015年间因鼻出血入院患者的病历。随访期定义为初次入院后3年。REA被分为初次入院后早期（30天内）和晚期（31天至3年）。采用逻辑回归分析确定REA的潜在预测因素。结果 共纳入653例患者。86例患者（14%）发生REA：48例（7.5%）为早期，38例（6.5%）为晚期。早期和晚期REA均呈现非线性发生率曲线。基于逻辑回归分析，既往鼻部手术和贫血是早期REA的独立危险因素。多因素分析显示，血小板减少与晚期REA显著相关。结论 早期和晚期REA具有不同的风险预测因素。了解这些危险因素有助于对这一特定患者群体进行风险分层。应向所有有风险的患者告知可能的预防措施。有早期REA风险的患者可能从更积极的治疗方法中获益。
