Chaaban Mohamad R, Zhang Dong, Resto Vicente, Goodwin James S
Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, United States.
Sealy Center on Aging, Galveston, TX, United States.
Auris Nasus Larynx. 2018 Aug;45(4):760-764. doi: 10.1016/j.anl.2017.11.010. Epub 2017 Dec 6.
Our objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly.
We used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months. We assessed the rates of ED visits for recurrent epistaxis in the 12 months following the incident visit. Our variables included demographics, geographic location, procedures performed during the incident visit and comorbidities.
Out of the 4120 patients with incident epistaxis, 775 were readmitted with recurrent epistaxis within 12 months. 60% presented in the first 30days and 75% within 90 days. There was a significant increase in ED visits for patients over 75 years of age and in men compared to women. Recurrent ED visits for epistaxis was higher in patients with congestive heart failure, diabetes mellitus, and obstructive sleep apnea compared to those without these comorbidities.
Additional ED visits for epistaxis are more common in the elderly and in males. Congestive heart failure, diabetes mellitus and obstructive sleep apnea were found to be independent risk factors.
我们的目的是确定与老年患者因复发性鼻出血而需到急诊科就诊相关的风险因素。
我们使用了2012年1月至2013年12月期间5%的医疗保险全国样本数据。我们的队列包括在急诊科新诊断为鼻出血的患者，定义为在过去12个月内无鼻出血。我们评估了初次就诊后12个月内复发性鼻出血的急诊科就诊率。我们的变量包括人口统计学、地理位置、初次就诊时进行的操作以及合并症。
在4120例初次鼻出血患者中，775例在12个月内因复发性鼻出血再次就诊。60%在最初30天内就诊，75%在90天内就诊。与女性相比，75岁以上患者和男性的急诊科就诊率显著增加。与无这些合并症的患者相比，充血性心力衰竭、糖尿病和阻塞性睡眠呼吸暂停患者因鼻出血再次到急诊科就诊的比例更高。
老年患者和男性因鼻出血再次到急诊科就诊更为常见。充血性心力衰竭、糖尿病和阻塞性睡眠呼吸暂停被发现是独立的风险因素。
