Min Hyun Jin, Kang Hyun, Choi Geun Joo, Kim Kyung Soo
1 Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
2 Department of Anaesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Otolaryngol Head Neck Surg. 2017 Dec;157(6):921-927. doi: 10.1177/0194599817721445. Epub 2017 Jul 25.
Objective Whether there is an association or a cause-and-effect relationship between epistaxis and hypertension is a subject of longstanding controversy. The objective of this systematic review and meta-analysis was to determine the association between epistaxis and hypertension and to verify whether hypertension is an independent risk factor of epistaxis. Data Sources A comprehensive search was performed using the MEDLINE, EMBASE, and Cochrane Library databases. Review Methods The review was performed according to the Meta-analysis of Observational Studies in Epidemiology guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Results We screened 2768 unique studies and selected 10 for this meta-analysis. Overall, the risk of epistaxis was significantly increased for patients with hypertension (odds ratio, 1.532 [95% confidence interval (CI), 1.181-1.986]; number needed to treat, 14.9 [95% CI, 12.3-19.0]). Results of the Q test and I statistics suggested considerable heterogeneity ([Formula: see text] = 0.038, I = 49.3%). The sensitivity analysis was performed by excluding 1 study at a time, and it revealed no change in statistical significance. Conclusion Although this meta-analysis had some limitations, our study demonstrated that hypertension was significantly associated with the risk of epistaxis. However, since this association does not support a causal relationship between hypertension and epistaxis, further clinical trials with large patient populations will be required to determine the impact of hypertension on epistaxis.
目的 鼻出血与高血压之间是否存在关联或因果关系一直是长期争论的话题。本系统评价和荟萃分析的目的是确定鼻出血与高血压之间的关联，并验证高血压是否为鼻出血的独立危险因素。 数据来源 使用MEDLINE、EMBASE和Cochrane图书馆数据库进行全面检索。 综述方法 根据流行病学观察性研究的荟萃分析指南进行综述，并按照系统评价和荟萃分析的首选报告项目指南进行报告。 结果 我们筛选了2768项独特的研究，并选择了10项进行此项荟萃分析。总体而言，高血压患者鼻出血的风险显著增加（优势比，1.532 [95%置信区间(CI)，1.181 - 1.986]；需治疗人数，14.9 [95% CI，12.3 - 19.0]）。Q检验和I统计量的结果表明存在相当大的异质性（[公式：见正文] = 0.038，I = 49.3%）。通过每次排除1项研究进行敏感性分析，结果显示统计学意义无变化。 结论 尽管这项荟萃分析存在一些局限性，但我们的研究表明高血压与鼻出血风险显著相关。然而，由于这种关联并不支持高血压与鼻出血之间存在因果关系，因此需要进一步开展大规模患者群体的临床试验来确定高血压对鼻出血的影响。
