Gomes Patrícia, Salvador Pedro, Lombo Catarina, Caselhos Sérgio, Fonseca Rui
Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal.
Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal.
Acta Otorrinolaringol Esp (Engl Ed). 2020 May-Jun;71(3):160-165. doi: 10.1016/j.otorri.2019.05.003. Epub 2019 Sep 11.
Epistaxis is one of the commonest causes of attendance of Otolaryngology emergency rooms. Given its incidence, potential severity and high recurrence rate, a systematic and careful management is mandatory. This work aims to define prognostic factors of epistaxis recurrence.
Retrospective review of medical records of patients with epistaxis admitted to our emergency department from January 2012 to December 2016. Data of 1005 patients with idiopathic epistaxis were analysed and independent risk factors for recurrence were determined by multiple logistic regression analysis.
Recurrence of epistaxis was found in 303 (30.1%) patients. Patients with recurrent epistaxis were older (p<.001) and more commonly had a history of hypertension (p=.001) and antiplatelet (p=.048) and anticoagulant (p=.001) use than those with episodic epistaxis. Age (adjusted OR 1.21, 95%CI 1.08-1.32, p=.003) and anticoagulant use (adjusted OR 2.68, 95%CI 1.94-3.70, p=.009) were predictors of increased risk of recurrent epistaxis. Gender, alcohol abuse, medical history, active bleeding at admission, unidentified bleeding point or treatment modalities were not associated with recurrence.
Age and use of anticoagulation drugs were risk factors for recurrence of epistaxis. None of the previously described risk factors for episodic epistaxis were found to increase the risk of recurrence. Knowledge of factors involved in recurrence might provide important information for assessment and management of increased risk patients.
鼻出血是耳鼻喉科急诊室最常见的就诊原因之一。鉴于其发病率、潜在严重性和高复发率，必须进行系统且仔细的处理。本研究旨在确定鼻出血复发的预后因素。
回顾性分析2012年1月至2016年12月期间入住我院急诊科的鼻出血患者的病历。分析了1005例特发性鼻出血患者的数据，并通过多因素逻辑回归分析确定复发的独立危险因素。
303例（30.1%）患者出现鼻出血复发。与偶发性鼻出血患者相比，复发性鼻出血患者年龄更大（p<0.001），更常伴有高血压病史（p=0.001），以及使用抗血小板药物（p=0.048）和抗凝药物（p=0.001）。年龄（校正OR 1.21，95%CI 1.08-1.32，p=0.003）和抗凝药物使用（校正OR 2.68，95%CI 1.94-3.70，p=0.009）是鼻出血复发风险增加的预测因素。性别、酗酒、病史、入院时活动性出血、未明确的出血点或治疗方式与复发无关。
年龄和抗凝药物的使用是鼻出血复发的危险因素。未发现先前描述的偶发性鼻出血的危险因素会增加复发风险。了解复发相关因素可能为评估和管理高风险患者提供重要信息。
