Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical and Medical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili, ASST Spedali Civili Hospital, Brescia, Italy.
Internal Medicine, Department of Clinical & Experimental Sciences, University of Brescia - Medicina Generale 2 - ASST Spedali Civili Brescia, Piazzale Spedali Civili,Brescia, Italy.
High Blood Press Cardiovasc Prev. 2024 Sep;31(5):493-500. doi: 10.1007/s40292-024-00669-7. Epub 2024 Sep 18.
Epistaxis is the most common otorhinolaryngological emergency and historically there have been an important debate whether there is a cause-effect relationship with high blood pressure.
This retrospective study explored whether hypertension is a significant risk factor for epistaxis in Emergency Department (ED) patients and examined associations between blood pressure levels and epistaxis episodes.
Two groups were studied: Group A (patients with epistaxis) and Group B (control). Patient characteristics, comorbidities, and medication use were recorded. Blood pressure measurements were taken upon ED arrival and after specialist evaluation. Statistical analyses included descriptive statistics, T-test, χ2 test, and logistic regression.
Group A, enrolled from April 2014 to February 2015, included 102 patients, mean age 67, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 73%, decreasing to 26% after 30 minutes. Group B, enrolled from May 2023 to August 2023, included 126 patients, mean age 59, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 60%, decreasing to 23% after 30 minutes. Both groups showed reduced blood pressure post-evaluation. Logistic regression identified anticoagulant and/or antiplatelet therapy as the main independent risk factor for epistaxis. Age, sex, blood pressure levels, and hypertension did not significantly influence epistaxis occurrence.
No significant correlation between hypertension and epistaxis was found. Anticoagulant and/or antiplatelet therapy was the primary independent risk factor, highlighting the importance of considering medication history in evaluating epistaxis.
鼻出血是耳鼻喉科最常见的急症，历史上一直存在高血压是否与鼻出血有因果关系的重要争论。
本回顾性研究探讨了高血压是否是急诊科（ED）患者鼻出血的显著危险因素，并检查了血压水平与鼻出血发作之间的关联。
研究了两组患者：A 组（鼻出血患者）和 B 组（对照组）。记录了患者的特征、合并症和用药情况。ED 到达时和专科评估后测量血压。统计分析包括描述性统计、T 检验、卡方检验和逻辑回归。
A 组于 2014 年 4 月至 2015 年 2 月入组 102 例患者，平均年龄 67 岁，男女比例 2:1。到达时的血压超过 140/90mmHg 的占 73%，30 分钟后降至 26%。B 组于 2023 年 5 月至 2023 年 8 月入组 126 例患者，平均年龄 59 岁，男女比例 2:1。到达时的血压超过 140/90mmHg 的占 60%，30 分钟后降至 23%。两组患者评估后血压均降低。逻辑回归确定抗凝和/或抗血小板治疗是鼻出血的主要独立危险因素。年龄、性别、血压水平和高血压与鼻出血的发生无显著相关性。
未发现高血压与鼻出血之间存在显著相关性。抗凝和/或抗血小板治疗是主要的独立危险因素，这突出了在评估鼻出血时考虑用药史的重要性。
