Ekber Karabulut Ali, Çevik Yunsur, Emektar Emine, Kerem Çorbacioğlu Şeref, Dağar Seda, Yardim Oğuz
Department of Emergency Medicine, Van Training and Research Hospital, Van, Turkey.
Department of Emergency Medicine, Kecioren Training and Research Hospital, Ankara, Turkey.
Turk J Emerg Med. 2018 Mar 2;18(2):67-70. doi: 10.1016/j.tjem.2018.02.001. eCollection 2018 Jun.
Recurrent epistaxis is one of the most common causes of emergency department visits. Although several localized and systemic conditions has been described, the exact cause is unknown in the majority of cases. In our study, we aimed to determine the effect of mean platelet volume (MPV) and red blood cell distribution width (RDW) levels on recurrent epistaxis.
One hundred and thirty six patients with recurrent epistaxis and 170 healthy cases as control group were included in the study. Demographic data, vital signs and the results of complete blood counts were recorded. The patients who had clinical conditions that might affect the levels of MPV or RDW, were excluded. MPV and RDW levels were compared between the two groups.
The median level of MPV was 7.6 fL (IQR25-75%: 7.1-8.4) in the study group and 8.2 fL (IQR25-75%: 7.8-8.9) in the control group (p < 0.001). The median levels of RDW were found in the patient and control groups in order %15.4 (IQR25-75%: 14.5-15.4) and %14.3 (IQR25-75%: 13.4-15.4) (p < 0.001). Systolic blood pressure, leukocyte count, age, sex, RDW and MPV levels that were variables with p levels<0.2, were included in the multivariate analyses. It was determined that high RDW levels increased epistaxis (p < 0.001; OR:1.89 [95% CI:1.53-2.33]) and high MPV levels decreased epistaxis (p < 0.001; OR:0.54 [95% CI:0.39-0.72]).
Low MPV and high RDW levels caused an increased bleeding tendency in patients with recurrent epistaxis. Although exact mechanism is not known, referring those patients for the assessment of etiologic causes would be proper.
复发性鼻出血是急诊科就诊的最常见原因之一。尽管已经描述了几种局部和全身状况,但大多数情况下确切病因仍不清楚。在我们的研究中,我们旨在确定平均血小板体积(MPV)和红细胞分布宽度(RDW)水平对复发性鼻出血的影响。
本研究纳入了136例复发性鼻出血患者和170例健康对照者。记录人口统计学数据、生命体征和全血细胞计数结果。排除可能影响MPV或RDW水平的临床状况患者。比较两组的MPV和RDW水平。
研究组MPV的中位数水平为7.6 fL(四分位数间距IQR25 - 75%:7.1 - 8.4),对照组为8.2 fL(IQR25 - 75%:7.8 - 8.9)(p < 0.001)。患者组和对照组的RDW中位数水平分别为15.4%(IQR25 - 75%:14.5 - 15.4)和14.3%(IQR25 - 75%:13.4 - 15.4)(p < 0.001)。收缩压、白细胞计数、年龄、性别、RDW和MPV水平作为p值<0.2的变量纳入多因素分析。结果确定,高RDW水平增加鼻出血风险(p < 0.001;比值比OR:1.89 [95%置信区间CI:1.53 - 2.33]),高MPV水平降低鼻出血风险(p < 0.001;OR:0.54 [95% CI:0.39 - 0.72])。
低MPV和高RDW水平导致复发性鼻出血患者出血倾向增加。尽管确切机制尚不清楚,但将这些患者转诊以评估病因是合适的。